Scholarship Application

Training Scholarship Application

Thank you for your interest in DreamFlight Charities' Flight Training Scholarships!

This online application features a variety of questions regarding your academic career, household income, and medical history. Before beginning this application, you will want to be sure to have the following information in hand:

• Current GPA
• Household Mortgage/Rent Payment
• Types of Governmental Aid & Additional Support

Other questions contained in this application include those pertaining to extracurricular activities, current aviation experience (if any) and goals, and community service.

In addition to your application submission, we also ask for two letters of recommendation. These letters should come from individuals not related to the applicant and can be submitted with this form, through our separate online form, by emailing info@dreamflightcharities.org, or by mail to:

DreamFlight Charities
Attn: Drew Underwood
165 Heart Lane
Campbellsville, KY 42718

For your application to be active, we require participation in one of DreamFlight Charities' Discovery Events or individually scheduled discovery flight through a partnering flight school. If you haven't participated in such an event already, you can view our calendar of upcoming events, or contact us at info@dreamflightcharities.org for help in scheduling an individual discovery flight.

Applicant Information

Applicant Photo (Max 2mb; JPG, PNG, or GIF file formats only)

Choose File

First Name

Last Name

Applicant Preferred Name

Applicant Date of Birth

Applicant Citizenship Status

Applicant Gender

Applicant Ethnicity

Applicant Phone/Mobile

Applicant Email

Permanent/Residential Address

Address Line 1

Address Line 2

City

State

Zip Code

Different Mailing Address (Yes/No)

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

School Information

School Name

School Address

Address Line 1

Address Line 2

City

State

Zip Code

Grade Level

Expected Graduation

Current GPA

Family & Household Information

Parent/Guardian A First Name

Parent/Guardian A Last Name

Parent/Guardian A Relationship

Parent/Guardian B First Name

Parent/Guardian B Last Name

Parent/Guardian B Relationship

Siblings (Yes/No)

Siblings Name & Age

Household Additional Information

Housing Information

Housing Type

Rent/Mortgage Amount

Governmental Aid & Additional Support

Does the applicant's family receive any of the following? (Check all that apply)

SNAP

Free or Reduced-Price Lunch

WIC

SSI

TANF

Medicaid

Child Support

Alimony

Child Support

Alimony

Household Income - Parent/Guardian A

Parent/Guardian A Employer

Parent/Guardian A Years Employed

Parent/Guardian A Pay Schedule

Parent/Guardian A Wage

Parent/Guardian A Hours

Household Income - Parent/Guardian B

*If Applicable

Parent/Guardian B Employer

Parent/Guardian B Years Employed

Parent/Guardian B Pay Schedule

Parent/Guardian B Wage

Parent/Guardian B Hours

Student/Applicant Income

*If Applicable

Applicant Employer

Applicant Years Employed

Applicant Pay Schedule

Applicant Wage

Applicant Hours

Other Income

*If Applicable

Other Income

Essay Questions

Perceived Strengths

Perceived Weaknesses

Aviation Goals

Volunteer & Community Service Experience

Hobbies & Extracurricular Activities

Additional Information

Are you willing to commit to varying community and fundraising opportunities designed to help reduce training costs for participants (like yourself) in our flight training scholarship program?

Please select your preferred training location.

Do you have reliable transportation to your selected flight training location?

What days would you be available for flight training and/or ground school? (Check all that apply)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Emergency Contact Information

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Relationship to Applicant

Emergency Contact Phone

Emergency Contact Email

Student Conduct Agreement

As an applicant and potential recipient of one of our flight training scholarships, I understand that all students have the right to learn in a safe environment and will make every attempt to show personal responsibility in allowing myself and others to accomplish this. understand that this will involve committed and regular attendance as scheduled, showing attentiveness during all lessons, operating aircraft and systems as instructed and within their recommended limitations, and treating staff and fellow students with courtesy, deference, and respect. I understand that failure to do so will result in the potential suspension of my training and scholarship.

Student Conduct Agreement (Yes/No)

Medical History

Have you ever held an FAA medical application/certificate that was denied, suspended, or revoked?

Do you wear glasses or contact lenses?

Have you ever in your life been diagnosed with or currently have any of the following? (Check all that apply)

Dizziness or Fainting Spells

Frequent/Severe Headaches

Unconsciousness for Any Reason

Eye or Vision Issues (Except for Corrective Lenses)

Hay Fever or Allergy

Asthma or Lung Disease

Heart of Vascular Trouble

High/Low Blood Pressure

Stomach, Liver, or Intestinal Issues

Kidney Stones or Blood in Urine

Diabetes

Neurological Disorders (Epilepsy, Seizures, Stroke, Paralysis, Etc.)

Mental Disorders of Any Sort (Depression, Anxiety, Etc.)

Substance Dependence or Failed Drug Test (Past 2 Years)

Alcohol Dependence or Abuse

Suicide Attempt

Motion Sickness Requiring Medication

Admission to Hospital

Learning Disorder (Dyslexia, Dysgraphia, Dyscalculia, Auditory, Etc.)

Other Severe Illness, Disability, or Surgery

None of the Above

Medical History Description

Current Medications

Doctor Name

Medical Insurance Company

Medical Insurance ID

Medical Insurance Phone Number

Policy Holder

Media Release Agreement

As part of our discovery flight events and flight training scholarships, my legal guardians give permission to have my name, photograph, and training experiences published via local or online media outlets or to further promote the operations of Dream Flight Charities.

Does your parent/legal guardian consent to the above Media Release Agreement?

Parent/Guardian Name (Media Release)

Parental/Guardian Consent

I understand that participation by my child involves a certain degree of risk. I have carefully considered the risk involved and give consent for my child to participate in such activities. I understand that participation in this program is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I hereby release Dream Flight Charities, activity coordinators, and all directors, officers, employees, volunteers, agents, and related parties from any and all claims or liability arising out of this participation.

In case of emergency involving my child, I understand every effort will be made to contact me or the individuals listed above. I further understand that I am financially responsible for any medical treatments or procedures that are necessary as a result of any injury sustained through the Dream Flight Charities training program. I also hereby authorize the above individuals to consent to proper treatment of my child should I be unavailable.

Proper treatment includes hospitalization, anesthesia, surgery, or injections for my child. Medical providers are authorized to disclose to the individuals above: examination findings, test results, and treatment provided for purposes follow-up and communication with the participant’s parents or guardian and/or determination of the participant’s ability to continue in the program activities.

I understand that my authorization is given in advance of any specific diagnosis and such diagnosis may later require specific consent before treatment can be provided. This authorization is valid only for the duration of my child’s participation in the Dream Flight Charities training program.

Parent/Guardian Electronic Signature

Date

Final Notes & Submission

Before submitting your application, please be reminded of the following:

1) Remember that your application remains inactive until you have participated in one of DreamFlight Charities' Discovery Events. You can click here for a schedule of upcoming events, or contact us at info@dreamflightcharities.org for more information.

2) Your application remains inactive until we receive two (2) letters of recommendations from persons not related to the applicant. These can be submitted by email to info@dreamflightcharities.org, through our online form, or by mail to:

Dream Flight Charities
Attn: Drew Underwood
165 Heart Lane
Campbellsville, KY 42718

3) Students selected for our flight training scholarships must obtain a Third Class Medical Certificate from an FAA Medical Examiner (estimated cost $100), while also providing both a) a copy of a government-issued ID, and b) birth certificate. Additional details will be provided as scholarships are awarded.

4) Your application will remain active for each selection process, so there is not need to submit additional applications. We may contact you to ensure information is up to date should it not be selected for upcoming training groups.

If you have any questions, concerns, or comments, feel free to contact us at info@dreamflightcharities.org.

Thanks again for your interest in our flight training scholarship, and don't forget to finalize and submit your application below!