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Enroll Your Son

Thank you for your interest in Flight36!

Please complete the form below and a Flight36 staff member will contact you to schedule an appointment to review your application and to answer any questions about our program.

* Application will be reviewed by the Flight36 Advisory Board.

Mother's Name (required):

Mother's Email (required):

Employer Name:

Employer Phone:

Home Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Son's Name:

Son's Date of Birth:

Church Name:

Pastor's Phone:

School Name:

School Phone:

Doctor's Name:

Doctor's Phone:

Insurance Carrier:

Ins. Policy Number:



Has he accepted Jesus Christ as his savior?
If so, please provide a brief description.

List the Sports/Hobbies that he enjoys.

Does he have any learning disabilities?
If so, please provide a brief description.

Does he have any physical or behavioral conditions?
If so, please provide a brief description.

Does he have any medical conditions or medications?
If so, please provide a brief description.

Briefly explain your son's strengths and talents he exhibits.

Briefly explain your son's weaknesses or character flaws he needs to work on.

Briefly explain the relationship with his father:

Briefly explain what you expect your son to benefit from Flight36.