The following information is requested to enable us to contact you and to maintain our database of industry professionals. The information you provide will NOT be released to the public. If an individual requests information on a specific career area that matches your expertise, AeroCareers’ directors will forward the request and their contact information to you. We will then ask you to contact the requester directly. We will NOT provide your information to any requester or suggest that they contact you directly unless you invite them to do so. It will be up to you to initiate the initial contact and open an appropriate line of communication. Thanks for your willingness to share your expertise with others.

FULL NAME (include appropriate title, e.g. Doctor, Captain, Professor, Senator, etc.):
PREFERRED NAME (i.e., nickname, abbreviated name, etc.):
EMPLOYER
JOB TITLE:
BRIEF JOB DESCRIPTION:

Please place an "X" by all items below that apply to your expertise:
PILOT (Please list ratings, type aircraft flown, and other significant pilot experience details.

AEROMEDICAL PROFESSIONAL
AEROSPACE EDUCATOR
AIR TRAFFIC CONTROLLER
AIRCRAFT MECHANIC
AIRCRAFT OPERATOR
AIRCRAFT OWNER
AIRCRAFT SALES, MANUFACTURING OR MARKETING
AIRLINES--OTHER THAN PILOT
AIRPORT FIREFIGHTER
AIRPORT MANAGEMENT
AVIATION ORGANIZATION LEADER
AVIATION/BUSINESS MANAGEMENT
BUSINESS OWNER/SENIOR MANAGER
ENGINEER
FAA (OTHER THAN ATC)
FIXED BASE OPERATOR
INTERNSHIP OPPORTUNITIES
MILITARY AVIATION EXPERIENCE
PILOT
SAFETY/ACCIDENT INVESTIGATION
SCHOLARSHIP OPPORTUNITIES
STATE AVIATION EMPLOYEE
OTHER (LIST BELOW):

TELEPHONE:
HOME: BUSINESS: CELL:

SEND MAIL TO MY HOME ADDRESS: OR BUSINESS ADDRESS:
HOME ADDRESS:
BUSINESS ADDRESS:
PREFERRED E-MAIL ADDRESS:
SECONDARY E-MAIL ADDRESS:

Would you be willing to respond to questions from individuals interested in your area of expertise?
Which statement best describes your willingness to participate in AeroCareers’ mission?
I am passionate about aerospace education and am willing to assist however and whenever I can.
I am passionate about aerospace education, but can only take time to respond to serious inquiries specific to my unique area of expertise.
I am willing to assist on a limited basis via e-mail only; or via both either e-mail or telephone.
I am willing to host in-person interviews and/or tours at my place of business.
Other—please explain:

Please take a moment to further explain what you are willing to offer individuals interested in aerospace careers and how you are willing to be involved with AeroCareers’ mission.


 Microsoft Outlook and many other e-mail programs will open a new e-mail message with pre-loaded text--click "send."

If for any reason you are unable to send the above information via e-mail, please print the page and mail it to:
AeroCareers
225 Carl St.
Columbia, IL 62236-1907