VAE Application

Name*

First NameLast Name

Known As

Date of Birth*

Date

Current Date

Date

Age

Unfortunately we are only able to accept applications if your age is 12 years or older. Please come back after your 12th birthday!

Gender*

What is your ethnic group?*

Aerobility uses this data to help develop its services, ensuring they are as accessible as possible to as many people as possible

Parent / Carer Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contact Number*

Email*

example@example.com

Are you interested in aviation and why? *

Please tell us about your disability and very generally how it affects you*

How might your disability affect your learning and participation on this course?*

Do you need a carer with you while you participate in an interactive course? (Microsoft Teams Meeting & Flight Simulator interaction)*

Do you have any particular support needs?*

Have you been a former beneficiary of Aerobility and, if so, how did you participate?*

When can you participate?

Weekdays OnlyWeekends OnlyAny Day of the Week

Do you have a preference for course session time?

You may select more than one (press ctrl and click)

Are there any sessions you cannot attend?

You may select more than one (press ctrl and click)

Is there any period of time when you know that you are unavailable?

What do you hope to gain from this course? *

Have you ever flown a flight simulator before? If so, approximately when, which simulator, and for roughly how many hours?*

Do you have access to a laptop or desktop PC with internet connectivity which supports a Microsoft Teams video and audio meeting?*

YesNo

The Simulator can be flown via 3 means: keyboard, mouse or joystick (specialised equipment such as EyeGaze can be setup via the ‘mouse’ option). Which method is your preferred choice?*

KeyboardMouseJoystickOther

Do you have a joystick? If so, what make and model?*

Does your joystick have 3 or more axes i.e. able to action up & down [pitch], left & right [roll], and left & right pivot motion [yaw]?*

If you do not have a joystick, do you require one to be provided to you or do you have your own alternative means of control? If so, please describe this equipment briefly (example: gyroscopic mouse which fits over the ear or on the brow)

If you do not have your own alternative equipment to a joystick, what equipment would you require in order to take part in the course? Please briefly describe below.

How did you hear about the course?*

For operational reasons we need to store your details for you to fly with us. If we loan you any equipment we may also need to share your contact details with our courier. Please select yes to consent to our storing your details and sharing information with our courier if required. We promise to protect your data and we will only contact you in relation to your course.*

Yes

We promise that your details will only be used as you wish and in line with data protection law. We will never share your details with another organisation (other than our courier) or contact you in a way you have not agreed to. However, we would like to send you communications from time to time about our organisation. If that would be ok, please tick if you are happy for us to contact you by:

EmailTelephoneSMSPost

If you don't want to hear from us, or change your mind about how we contact you, please email frontdesk@aerobility.com or call 0303 303 1230. For more information on how we manage your data, please see our privacy policy.

About You

About Your Disability

About This Course

Data Protection