A500 Information Request

Mr.  Mrs.  Ms.  Miss

First Name:  
Last Name:   
Address:     
City:   
State:  
Zip:    

Home Phone:  
Work Phone:  
Cell Phone:  

Do you have a pilot's license?  Yes  No

If yes, what ratings do you hold?
Private
Commercial
Instrument
Multi-engine

How many hours have you logged?  

Approximate hours flown per year:  
Less than 10
10-25
25-50
50-100
more than 100

Do you currently have an aircraft?  Yes  No
If yes, what type?  

Do you use your aircraft for:  
Pleasure
Business
Both


I plan on acquiring a new aircraft:  within the next 30 dayswithin the next 6 monthssometime this yearno immediate plans

Proposed use:  PersonalBusinessBoth

I most likely will:  PurchaseLeaseNot sure

I am primarily interested in:  SE FixedSE RetractableMERotary WingOther
If Other, specify:  

Important features I would like to have:
Radar
IFR
GPS
Auto Pilot
Turbo
Strike Finder
Other
If Other, specify:  

Household income:
$15,000 - $24,999          $50,000 - $74,999
$25,000 - $29,999          $75,000 - $99,999
$30,000 - $39,999          $100,000 - $149,000
$40,000 - $49,999          Over $150,000

Please contact me for a demonstration flight:  Yes  No