First Name |
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Middle Name |
|
Last Name |
|
Email Address |
|
Country of Birth |
|
Country of Citizenship |
|
Date of Birth |
|
City of Birth |
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Race |
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Sex |
|
Weight (lbs) |
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Height (ins) |
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Marital Status |
|
Occupation |
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Branch |
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Rank |
|
Months of Active Duty |
|
Last Day of Duty or ETS |
|
FAA Pilot Certificate Held |
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FAA Medical Held |
|
ICAO Pilot Certificate Held |
|
ICAO Country |
|