MIDWEST FLYER MAGAZINE

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Dave Weiman
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DATE
NAME*
ADDRESS*
CITY*
STATE*
ZIP CODE*
EMAIL ADDRESS
(X) Please check or answer only those items that apply:
Pilot
Aircraft Owner
Flying Club Member
Airport Official
FBO
State Aviation Official
FAA Official
Other (please specify):
What are the top three (3) aviation topics you are most interested in reading about?
State/Regional News
Travel
National News
Airport Restaurant Reviews
Maintenance
Safety
FAA Info
Pilot/Aircraft Owner Advice
Events/Activities
Calendar
Pilot Education
New Products
Technical
Pilot Health
History
State DOT Aeronautics Reports
Aircraft
Avionics
Awards
Airports
Other (please specify):
In your opinion, what is the single most important issue facing General Aviation today?
Airspace Restrictions
Airport Security
FAA Regulations
Loss of Airports
Pilot Medical
Fuel Costs
Insurance Availability
Cost of Aircraft Ownership
Insurance Costs
Other (please specify):
Type of Aircraft You Own:
Single
Light Twin
Cabin Twin
Turboprop
Jet
Other (please specify):
Highest Pilot Certificate:
Sport Pilot
Private
Commercial
CFI
CFII
ATP
Pilot Ratings:
Single-Engine Land
Single-Engine Sea
Multi-Engine Land
Multi-Engine Sea
Instrument
Pilot Endorsements:
Tailwheel
Complex Gear
High-Performance
High-Altitude
Pilot Categories/Classes:
Fixed Wing/Airplane
Rotary Wing/Helicopter
Ultralight
Jet
Glider
Hang Glider
Light Sport Aircraft (LSA)
LSA Helicopter
Gyrocopter
Hot Air Balloon
Gas Balloon
Airship
Number of Hours Flown Per Year:
Less than 100
100 to 150
150 to 200
200 to 300
300 or more
Number of Total Hours Logged:
Less than 500
500 to 1,000
1,000 to 2,000
2,000 to 3,000
3,000 or more
Furthest travel destination you have flown to as pilot-in-command in past 3 years:
Rockies
West Coast
East Coast
South
Southeast
Southwest
Canada
Alaska
Bahamas
Other Caribbean
S. America
Europe
Membership?
AOPA
EAA
NBAA
NATA
AAAE
NASAO
Other (please spell out):
DEMOGRAPHICS
Male Female   Age
Highest Education:
High School
Some College
Bachelor’s
Master’s
PhD
Occupation:
Self-Employed
Skilled Trade/Profession
Management
Other
Retired
Annual Household Income:
Under $100,000
$100,000 to $250,000
$250,000 to $500,000
$500,000 to $1 million
$1 million-plus
What sports do you enjoy?
Hunting
Fishing
Boating
Tennis
Golf
Biking
Skiing
Hiking
Camping
 

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