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Tailwind Flight Center Renter Information

2009 Airport Dr. Green Bay, WI 54313


P: 920.498.2722 Fax: 920.965.7255 Date: ____________________

Full Name: _______________________________________________ D.O.B. _____________________

Permanent Address: ____________________________________________________________________

Seasonal Address: _____________________________________________________________________

Primary Phone #: ____________________________ Alternate Phone #: __________________________

E-mail Address: _______________________________________________________________________

Driver’s License # and State: _____________________________________________________________

Pilot’s Certificate # and Grade: ___________________________________________________________

Insurance Company: ____________________________________________________________________

Insurance Policy #: _____________________________________________________________________

Tailwind listed as additionally insured on customer aircraft?  Customer has renter’s insurance? 

Pilot Flight Experience: Ratings and Endorsements held by Pilot:

_______ Total hours


 Instrument
 Multi-engine
_______ Time in Type
 Tailwheel
 Complex
Medical Certificate:
 High-performance
 First Class  High-altitude
 Second Class
 Third Class

_________________ Examination Date


 Over age 40?
 Under age 18?

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