LA CROSSE AVIATION EXPLORER EXPLORING INTEREST FORM Thank you for your interest in the Aviation Exploring program sponsored by the La Crosse Regional Airport, Exploring.org, and Gateway Area Council BSA. Here is important information to be an applicant: REQUIREMENTS: AGE: Currently enrolled in high school. APPROVALS: Have parent / guardian approval to participate in Explorer activities. ADDITIONAL RQMTS: Have a desire to learn. Make a commitment to attend at least 10 of 15 meetings. APPLICATION PROCESS: Complete and submit an Aviation Exploring interest form by email to Elizabeth Kramer at gatewayexploring@gmail.com or to your school’s guidance counselor or bring to the Open house on Monday, Sept. 23, 2019. Pay registration fee/ annual dues $37 (Due at 1st meeting 10/14/19. Scholarships are available.) A selection of applicants will be made based on application responses, meeting above requirements and space availability. A notification of acceptance or non-acceptance will be made in writing via email.   GUIDELINES Attend monthly meetings and training sessions, arriving 10 minutes early or no later than on time. Prompt pickup of student. No use of cell phones during the exploring meetings unless it is required for the activity. If the explorer cannot make a meeting, they must notify Miranda TerBeest at 608-789-3862 or gterbeestm@lseairport.com before the meeting or it will be an “unexcused absence.” APPLICANT DISQUALIFICATION OR TERMINATION FACTORS: Applicants are advised that areas for disqualification from further consideration or termination from program include, but are not limited to, the following: Two unexcused absences (no phone call or message sent ahead of session). Misconduct or behavioral disruption in exploring sessions. Dates for Aviation Exploring Meetings OPEN HOUSE Monday, September 23, 2019 3:30 – 5:30pm 1. Monday, October 14, 2019 3:30 – 5:30pm 2. Monday, October 28, 2019 3:30 – 5:30pm 3. Monday, November 11, 2019 3:30 – 5:30pm 4. Monday, November 25, 2019 3:30 – 5:30pm 5. Monday, December 9, 2019 3:30 – 5:30pm Monday, January 13, 2020 3:30 – 5:30pm Monday, January 27, 2020 3:30 – 5:30pm 8. Monday, February 10, 2020 3:30 – 5:30pm 9. Monday, February 24, 2020 3:30 – 5:30pm 10. Monday, March 9, 2020 3:30 – 5:30pm 11. Monday, March 23, 2020 3:30 – 5:30pm 12. Monday, April 13, 2020 3:30 – 5:30pm 13. Monday, April 27, 2020 3:30 – 5:30pm Monday, May 11, 2020 3:30 – 5:30pm

LA CROSSE AVIATION EXPLORER EXPLORING INTEREST FORM APPLICANT INFORMATION LAST NAME FIRST NAME MIDDLE NAME DATE ADDRESS (STREET, CITY, STATE, ZIP) EMAIL ADDRESS OF STUDENT HOME PHONE CELL PHONE DATE OF BIRTH MALE / FEMALE PARENT / GUARDIAN NAME (1) PARENT / GUARDIAN NAME (2) EMAIL ADDRESSES OF PARENTS OR GUARDIANS (required) ADDRESS IF DIFFERENT THAN YOURS PARENT / GUARDIAN PHONE NUMBERS WHAT SCHOOL DO YOU ATTEND? CURRENT GRADE LEVEL LAST SEMESTER’S GPA WHAT EXTRA-CURRICULAR ACTIVITIES DO YOU PARTICIPATE IN OUTSIDE OF SCHOOL? PLEASE DESCRIBE YOUR ATTENDANCE RECORD FOR LAST SCHOOL YEAR (# DAYS ABSENT LAST YEAR) ARE YOU ABLE TO COMMIT TO MAKING AT LEAST 10 OUT OF 15 OF THE MONDAY MEETING DATES (3:30 TO 5:30PM): YES / NO KNOWN EXCEPTIONS AT THIS TIME: ARE YOU EMPLOYED? EMPLOYER HOURS PER WEEK JOB DUTIES EXPLAIN WHY YOU WANT TO EXPLORE A CAREER IN AVIATION I certify that I have read the requirements set forth for the position applied for, and attest that all statements made by me on the application are true and any false statements will result in disqualification for consideration or termination as a member of the Aviation Explorer program. Signature _____________________________________________ Date ___________________ Name (printed) _____________________________________________ Parent / Guardian Signature _____________________________________ Date ___________________ Submit participation request by email to Elizabeth Kramer at gatewayexploring@gmail.com or to your school’s guidance counselor or to the OPEN HOUSE by Monday, Sept. 23, 2019.