Request for Information

If interested in learning more about how langaAir can help you reach your dream of flight or

if you just have a question or comment, please provide the following:

Sorry, but we do not currently offer flight training for international students in need of a visa.

Info in Bold is required.

First Name:

Last Name:

Address

Address

City

State

Zip

Daytime Phone:

Evening Phone:

Email Address:

Date of Birth

Prior Flying Experience:

Interested In:

Recreational Flying

Business Flying

Career Flying

Finish-up of a rating or training regiment

Specific Courses (If known):

Housing Needed    Yes

Financial Assistance Needed    Yes

Desired Start Date

How Did You Hear About Us:

If through the web, which specific search engine:

Questions or Comments:

langaAir

St. Louis Regional Airport

800-624-9068

618-258-1005

618-258-1007 (fax)

First Name:
Last Name:
Address
Address
City
State
Zip
Daytime Phone:
Evening Phone:
Email Address:

Date of Birth
Prior Flying Experience:
Interested In:	Recreational Flying Business Flying Career Flying Finish-up of a rating or training regiment
Specific Courses (If known):
Housing Needed	Yes
Financial Assistance Needed	Yes
Desired Start Date
How Did You Hear About Us:
If through the web, which specific search engine:
Questions or Comments: