National Black Coalition of Federal Aviation Employees (NBCFAE)
and the
TheOrganization of Black Aerospace Professionals (OBAP)
In association with
Presents the 18th Annual
Aviation Career Education(ACE)Academy Application
JULY 10, 2017 – JULY 14, 2017
SPECIAL SPONSORSHIP FROM:
TheNational Black Coalition of Federal Aviation Employees (NBCFAE) and the Organization of Black Aerospace Professionals(OBAP) will hold its18th Annual AviationCareerEducation(ACE)Academy this coming July..
This Campis designed toprovideanmorein-depth lookatthe aviation industryforstudentswhoare lookingwant to explore the possibility of a career in aerospace, engineering , engineering, or technology or other STEM-related career fields.. We offer classroom discussion,field trips toaviation- relatedentities, includingaircrafthangars, towers and , even flight in a private aircraft. This could more than spark the interest of students with minimal technology aspirations to become highly motivated, engineer-drivenstars.
Thetargetagegroupismiddletohighschoolstudents,ages14-17years. Capacity is 25students with five (5) alternates that will only be considered through attrition of otherbased on student cancellations prior to the Camp start time.
The Camp will start at 8:00 a.m. Monday through Friday at the Northern Virginia Community College Manassas Campus(6901 Sudley Road, Manassas, VA 20109). The room number along with other required documents will be emailedto the parent or guardian approximately one (1) week prior to the Camp start date. Be sure to provide the email address of the person responsible for the student during the week of the Camp.
A morning snack and lunch will be provided each day as well as transportation to all field trips. Each student will also receive a and CampT-shirt to be worn each day.
The cost of the camp is $125.00 and is NON-REFUNDABLE. You can check availability prior to sending your payment by contacting Glenda Mickens at (703) 371-2664. Payment must be in the form of acashier’s check or money order via mail to the address belowon the application form. You may submit the application via email to Glenda Mickens at ;, however, yourpaymentmustbereceived beforeacceptancecan be granted. soallowample timeforpayment arrival.
ALL STUDENT MUST HAVE A VALID PHOTO ID SUCH AS
sTATE id
cURRENT pASSPORT
SCHOOL ID
APPLICATION DEADLINE IS FRIDAY, JUNE 16, 2016
Complete Pages 1-6 and mail to:
National Black Coalition of Federal Aviation Employees
ACE Camp Coordinator
2819 Bixley Hill Court
Woodbridge, VA 22191
PartI:StudentInformation: Datecompleting application:
Name: DateofBirth:
Address:
City: State: ________ Zip: ______
Home Phone :: (_( ____)_) __________________ Cell_ CellPhone: (____)_)_______
Citizenship: ____________ Male ___ Female ______
(Non-US Citizen will be restricted from certain tours)
GradeLevel in Fall2017: Current GPA: School: ______
Haveyouattended this programbefore? Yes No If yes,howmanyyears___
Student’sshirtsize: AdultSmall Adult Medium AdultLarge Adult XL Adult2XL
Howdidthestudentfind outabouttheAcademy?
Has thestudent hadanyflightexperience? Ifyes,howmanyhours? _
List communityactivities,hobbies andinterests:
PartII: Student Interest
Pleasebrieflydescribe[G1][gm2]whyyou wouldliketoattendour SummerACE AviationAcademy. Attachadditional sheetsfor youressay.
Project Aerospace – SummerAcademyProgramApplication
Parental/Guardian Information and Approval(s)
The ParentorGuardianmust reviewandcompletethissection.
Important–this partoftheapplicationMUSTbecompletedandsigned forconsiderationof admissiontothe academy.
Parents/Guardian Information
Name: ______
Address: (If different from student) _) _______
City: ______
State: Zip: ______
Home# Work# Cell/Other# ______
Email:
EmergencyContact(otherthanparentor guardian)
Name: Relationshiptostudent:
Phone:( ) Cell/Other# _
Student’s Medical History:
Doesthestudenthaveanyhealth concerns/allergies/medicationsthatweneedtobeawareof?
Yes
No Ifyes, pleaseexplain: _
Doesthestudenthaveanydietaryneeds/foodallergiesthatweneedtobeaware of?
Yes ______No ______ if yes, please explain: ______
Please list or describe any physical limitations: ______
Emergency Medical Contact Information
Name of Primary Physician:
Phone: Insurance Provider: ______
Yes ______No _______ If yes, please explain: ______
Please list or describe any physical limitations: ______
______
Emergency Medical Contact Information
Name of Primary Physician:
Phone: Insurance Provider: ______
PersonsAuthorizedtoPickUp Student up:
Name: _RelationshiptoStudent:
Phone:Home Cell/Work
Name: _RelationshiptoStudent:
Phone:Home Cell/Work ______
Contact the ACE Academy Coordinator at (703) 371-2664 if you have any questions at (703) 371-2664.
Project Aerospace [G3][gm4]– Summer Academy Program Application
ConsentFormAndandRelease Statements
Student’s Name(Please Print):
Theundersigned ("Participant")herebyacknowledgesthathe/shehas voluntarilychosen toparticipateinthe summer aviation orflightacademysponsored bytheOrganizationof BlackAerospaceProfessionals("OBAP")andtheNational BlackCoalition of Federal Aviation Employees (“NBCFAE”) or anyadditional collaboratingpartnersof OBAP.Participant acknowledgesandunderstands thattheOBAP/NBCFAEsummeraviationor flightacademywillinvolvestrenuous physical activity thatcouldpotentiallybedangerousor harmful.Participanthaschosentoparticipateintheacademy voluntarily,with thefull knowledge ofthis potential dangerandharm.Bysigningthis document,Participantrepresents andwarrantsthat he/shedoesnothaveanyphysical condition, whichcouldbeaggravatedor worsened bystrenuous physical activityor stress. InconsiderationofOBAP/NBCFAEpermittingParticipanttoparticipateinthissummer aviationacademy,Participantwaivesallclaims, demands, actions, causesof action, andliabilitiesofanykindor nature, whetherbased inlawor inequity, againstOBAP/NBCFAE orothercollaboratingpartnersof OBAPincludingwithout limitation, its parentandits successors, subsidiaries andaffiliates("Affiliated Companies")arisingoutoforinanyway relatedto theOBAP/NBCFAEsummeraviationor flightacademyorParticipant'sparticipationin theevent,including withoutlimitationclaims for physical or other personal injury("Claims").ParticipantreleasesOBAP/NBCFAEandits Affiliated Companies fromsuchClaims,regardlessofwhen suchClaimsariseorwhen Participantdiscoversanyinjuryor damagethat doesormaygiverisetosuchClaims.
Iherebygiveconsentfor mychildtoparticipateintheOBAP/NBCFAEAviationCareerEducation(ACE)Academyor
Solo Flight Academy and travelonallfieldtrips.
______
Student SignaturePrint Name Date
______
Parent/Guardian’sSignature[G5] PrintName Date
MedialRelease
I herebygrantpermissionto OBAP and its partnerstotake and reproduce photographs,videosorprogramcommentsofmyson/daughter to beused inconnectionwiththemaking, promotionorpublicrelationsforeducational programs,trade, advertising and other purposes as determined by OBAP/NBCFAE. OBAP or various other media may choose to take pictures or videotape of participants in OBAP activities. These images may be used for OBAP displays, brochures, newsletters, archives, new releases, publicity and website.
______
Parent /Guardian’s Signature [G6]Date
MILITARY INSTALLATION VISIT and MILITARY RECRUITER PRESENTATION RELEASE
I understand and acknowledge that during the OBAP/NBCFAE ACE Academy [LG7]that my son/daughter, may enter and tour a military installation and/or fly on a military aircraft as part of the camp’s itinerary. Additionally, recruiters from the U.S. Military may visit and speak on behalf of their respective organizations. I hereby grant permission to OBAP/NBCFAE and/or its agents to allow my Son/ Daughter to visit such installations, listen to their presentations, and to speak to their representatives. The ACE Camp is not a recruitment activity.
Parent /Guardian’s Signature Date
Parent/Guardian Academy Agreement
-Parents will ensure that students arrive at the academy on time every day
-Parents will ensure that students are picked up on time at the end of every day
-Parents will ensure that students bring all required materials to the academy every day
-PARENTS WILL SIGN STUDENTS IN/OUT OF THE ACADEMY EVERY DAY
Parent /Guardian’s Signature Date
ALL STUDENT MUST HAVE A VALID PHOTO ID SUCH AS:
- sTATE id
- cURRENT pASSPORT
- SCHOOL ID
Project Aerospace [G8]– Summer Academy Program Application
MILITARY INSTALLATION VISIT and MILITARY RECRUITER PRESENTATION RELEASE
I understand and acknowledge that during the OBAP/NBCFAE ACE or Solo Flight Academy [LG9]that my son/daughter, may enter and tour a military installation and/or fly on a military aircraft as part of the camp’s itinerary. Additionally, recruiters from the U.S. Military may visit and speak on behalf of their respective organizations. I hereby grant permission to OBAP/NBCFAE and/or its agents to allow my Son/ Daughter to visit such installations, listen to their
presentations, and to speak to their representatives. The ACE Camp is not a recruitment activity.
______
Parent / Guardian’s Signature Date
PARENT/GUARDIAN ACADEMY AGREEMENT
-Parents will ensure that students arrive at the academy on time every day
-Parents will ensure that students are picked up on time at the end of every day
-Parents will ensure that students bring all required materials to the academy every day
-PARENTS WILL SIGN STUDENTS IN/OUT OF THE ACADEMY EVERY DAY
Parent / Guardian’s Signature Date
Project Aerospace [LG10]– Summer Academy Program Application
STUDENT ACADEMYAGREEMENT
Pleasereadtheinformationlistedbelowandsignatthebottomofthe page
STUDENTGUIDELINES
- Drugs, alcohol, tobaccoproducts,weapons, beepers,laser pointers,electronicdevices/games,
iIPods,mp3players,radios, arenotpermittedandwill beconfiscated.Cell phonesmustbeturnedoff exceptduringbreaks.
- Studentsmustreport ontimeeach dayor riskmissingthefieldtrips.
- Studentsmustparticipatein alldailyactivities.
- Studentsmustwear ACE/Solo FlightAcademyT-shirt, appropriateshorts,slacks,jeansor skirts,tennisor sporttype shoesandnametageveryday.
- On fieldtrips,we’ll beinairporthangars,climbinginand outof airplanesand othertypesof activities, so, foryoursafety, nosandalsoropen- toedshoes,noshortshorts,shortskirts, baggy oversized style jeans, andnofacial jewelrysuchasnoseor eyebrowrings.
- ParentsmustsignStudentsINandOUTof theacademydaily. Students arenotallowed toleave early withoutprior coordinationbetween parentsand ACE/ SoloFlightAcademyprogram directors.
- Studentsmustusethesponsor-provided transportationforfield trips.
SAFETYTIPS
- This is afast-paced week—Payattentionto whatisgoingonaround you.
- Watchoutforsharpobjectsaroundaircraft/equipment--especiallyateyelevel.
- Takecareenteringandexiting: 1. Bus 2Bus 2. Aircraft 3Aircraft 3. Otherfacilities.
- Your AcademyDirectors anddesignatedFlightInstructorswill brief youonall specialemphasis
s safetyrestrictions items for theday. Paycloseattentiontothesebriefings andabidebyallof therulestoensure maximumsafety. Reckless behaviorwillnotbetolerated.
- OurAcademyCoordinators havedesigned theweekof activitiestoensureyoursafetythroughoutthe academy;however, youareultimatelyresponsiblefor yourown safetyandassuringyouhaveasafe week.
- Any student or parent that will require parking for more than 1 hour must contact the ACE Camp Coordinator at (703) 371-2664 for a parking permit. [G11][gm12]
Ihavereadandunderstandallof theinformationlistedabove,andIagreetofollowallstudentguidelines andsafety tipswhileattendingtheACEAcademy.
Student Name_ _Signature/Date
If you have any questions, please contact the NBCFAE ACE Coordinator at (703) 371-2664
APPLICATIONS MUST BE POST MARKED BY TUESDAY, JUNE 20, 2017
[G1]Do you want a word limit? Maybe 250 words or less?
[gm2]I don’t think its needed. If they want to submit 5 pages, I’m okay with it.
[G3]id you mean “Project Aerospace?” Terminology not previously mentioned.
[gm4]Reference to Solo Flight and Project Aerospace Deleted. Thanks
[G5]Seems like you would need the child’s signature too.
[G6]Add signature line
[LG7]Did you intend to leave this reference to Solo Flight Academy?
[G8]Same comment as above
[LG9]Did you intend to leave this reference to Solo Flight Academy?
[LG10]Same comment
[G11]How far in advance?
[gm12]