B212 Airframe - PT6T 3/6 Series Engine Registration Form

B212 Airframe - PT6T 3/6 Series Engine Registration - Feb 2020

Fill out the form carefully. Payment is required ten days prior to course start date.
Choose Option *

B212 Airframe/ PT6T 3/6 Engine Feb 10 - 22 = $7,998.00 B212 Airframe Only Feb 10 - 18 = $6,998.00 PT6T 3/6 Engine Only Feb 19 - 22 = $3,498.00
Course Location

Airspan Helicopters 4480 Hiltop Road, Sechelt, BC.
How much experience on the type? *
Number of years
Name On Certificate *
Type exactly how it should appear
Legal Name *

First Name Last Name
Birth Date *

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Your Personal Email *

Confirmation Email
Mobile Or Preferred Number *

Area Code Phone Number
Emergency Contact Name *
Emergency Contact Name
Emergency Phone *
Emergency Contact Phone
Please complete company information if course is paid by employer or company
Company
Work Phone Number

Area Code Phone Number
Your Work Email Address
DOM/PRT
Name
DOM/PRT
Phone
DOM/PRT
Email
WestPoint Helicopter Industry Services Inc.
1215-C - 56th St. Box 18053, Delta, BC V4L 2B0
Phone: 604 271-4354
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B212 Airframe - PT6T 3/6 Series Engine Registration - Feb 2020