Jan Jones Memorial Scholarship Application

Your Name (required)

Address (required)

City, State, Zip/Postal Code (required)

Home Phone Number

Cell Phone Number

Alternate Phone Number

Your Email (required)

Date of Birth

Your Gender

List currently held Pilot’s Certificates (Note: Certificates will be verified by the selection committee from the FAA’s database of airman certificates):

Flight Hours

Current Occupation

Education (Certificates, Degrees, Areas of Study):

Other Notable Activities:

Date of Application

Essay Instructions: Write an essay on why you want to receive the Jan Jones Memorial Scholarship, how the funds will be used, your goals, and why you wish to learn aerobatics.

Local newspapers - please provide the name of the paper and the city in which it is published:

Local Airports or Fixed Base Operations:

Websites (Optional) - please provide links to additional information about you, if applicable:

Biographical Information – please provide below a short one-paragraph narrative describing yourself. Consider including information about where you were raised, where you live, what you do, your aviation activities, your other interests, family members, and notable accomplishments:

In the event you are selected, you will be asked to provide a high-resolution digital photograph of yourself. The photo must be at least 300 dpi at 3.5×5 inches; photos of this quality can be produced from digital cameras with a minimum of 2 megapixels. Photos produced on a camera-phone cannot be used.