USPA Course Registration Form

Please fill all spaces of the form in entirety to enable us to accommodate you best! Once submitted, you will receive a confirmation email from us once we’ve reviewed all of your information.

USPA Instructor Course Registration Form

Name *

First

Last

Email *

Phone

Address *

What course are you registering for? *

USPA Coach Rating Course (€100 Deposit)
USPA AFF Instructor Rating Course (€250 Deposit)
USPA/UPT Tandem Rating Course (€250 Deposit)
Vector/Omega Tandem Rating Course (€250 Deposit)
Conversion to AFF Instructor Rating (€100 Deposit)
Conversion to USPA Tandem Rating (€100 Deposit)
Conversion to UPT Tandem Rating (€100 Deposit)

Please see below for bank details for deposits.

Preferred Date of Course *

If dates are scheduled already for your desired course, please list them here. If no dates are scheduled, please list when you are able to attend a potential course.

USPA Membership Number *

If you don't have a membership yet, please register at https://uspa.org/register prior to submitting this form.

USPA Membership Expiry Date *

USPA License Number *

If you don't have a USPA License yet, please write your current license number and country of issue.

Current Ratings Held

Please list all ratings held and country of issue.

Total Number of Jumps *

Total Freefall Time *

Date of First Solo Skydive *

Please note that this is not your first tandem jump, it must be your first solo skydive.

Do you have a Class 2 Aviation Medical (for Tandem Rating Only)?

Please note that an Aviation Medical is required for a tandem instructor rating. If you need help with this, please let us know.

Comment or Message

Please send course deposits to the following account: Richelle Hall @ N26 Bank. IBAN: DE83100110012620181526, BIC: NTSBDEB1XXX with description "(name) and (payment for -------- course)".

Name