SampleForm

[et_pb_section bb_built=”1″ _builder_version=”3.0.89″ background_color=”#0c71c3″ use_background_color_gradient=”on” background_color_gradient_end=”#ffffff”][et_pb_row][et_pb_column type=”4_4″][et_pb_contact_form _builder_version=”3.0.89″ title=”Eagle Sport Aviation Club MEMBERSHIP APPLICATION FORM DEMO ONLY” captcha=”off” use_redirect=”off” custom_button=”off” button_icon_placement=”right” submit_button_text=”Submit Application” email=”juanjartigas@gmail.com”] [et_pb_contact_field field_title=”Last Name” field_type=”input” field_id=”LastName1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22email%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”First Name” field_type=”input” field_id=”FirstName1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22email%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”Street Address (local)” field_type=”input” field_id=”StreetAddress1″ required_mark=”on” fullwidth_field=”on” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”City” field_type=”input” field_id=”City1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”State” field_type=”input” field_id=”State1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”2″ allowed_symbols=”letters” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”Phone (Local)” field_type=”input” field_id=”Phone_local1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”Cell” field_type=”input” field_id=”Phone_cell1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”Date of Birth” field_type=”input” field_id=”Date_of_Birth1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Name%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field field_title=”Email Address” field_type=”email” field_id=”Email1″ required_mark=”on” fullwidth_field=”off” _builder_version=”3.0.89″ checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22Email Address%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Email Address%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Email Address%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Pilot_Certificate1″ field_title=”Pilot Certificate #” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Certificate1″ field_title=”Certificate (choose highest)” field_type=”select” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Student%22,%22checked%22:0},{%22value%22:%22LSA%22,%22checked%22:0},{%22value%22:%22Private%22,%22checked%22:0},{%22value%22:%22Commercial%22,%22checked%22:0},{%22value%22:%22Certified Flight Instructor%22,%22checked%22:0},{%22value%22:%22ATP%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Medical_Issue_Date_1″ field_title=”Medical Issue Date” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Medical_Type_1″ field_title=”Medical Type” field_type=”select” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Class I%22,%22checked%22:0},{%22value%22:%22Class II%22,%22checked%22:0},{%22value%22:%22Class III%22,%22checked%22:0},{%22value%22:%22No Medical %22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Emergency_Contact_Name_1″ field_title=”Emergency Contact Name” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Emergency_Contact_Phone_1″ field_title=”Emergency Contact Phone” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”MembershipType11″ field_title=”Membership Type” field_type=”select” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Social Flyer%22,%22checked%22:0},{%22value%22:%22Frequent Flyer%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Student_Status11″ field_title=”Are you a student at ERAU or any other University?” field_type=”radio” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0},{%22value%22:%22No%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Authorize_Billing” field_title=”Do you authorize ESA to charge your credit card for agreed upon purchases and that this information will be saved for future transactions on your account?” field_type=”radio” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0},{%22value%22:%22No%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”CardType11″ field_title=”Card Type” field_type=”select” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Visa%22,%22checked%22:0},{%22value%22:%22MasterCard%22,%22checked%22:0},{%22value%22:%22AMEX%22,%22checked%22:0},{%22value%22:%22Discover%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”on” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22authorize_billing%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”CardholderName11″ field_title=”Cardholder Name (as shown on card)” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Visa%22,%22checked%22:0},{%22value%22:%22MasterCard%22,%22checked%22:0},{%22value%22:%22AMEX%22,%22checked%22:0},{%22value%22:%22Discover%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”on” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22authorize_billing%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”CardNumber11″ field_title=”Card Number” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Visa%22,%22checked%22:0},{%22value%22:%22MasterCard%22,%22checked%22:0},{%22value%22:%22AMEX%22,%22checked%22:0},{%22value%22:%22Discover%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”numbers” required_mark=”on” conditional_logic=”on” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22authorize_billing%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Expiration_Date11″ field_title=”Expiration Date (mmyy)” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Visa%22,%22checked%22:0},{%22value%22:%22MasterCard%22,%22checked%22:0},{%22value%22:%22AMEX%22,%22checked%22:0},{%22value%22:%22Discover%22,%22checked%22:0}%93″ min_length=”4″ max_length=”4″ allowed_symbols=”numbers” required_mark=”on” conditional_logic=”on” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22authorize_billing%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”CV2_Code11″ field_title=”CV2 (Security Code)” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Visa%22,%22checked%22:0},{%22value%22:%22MasterCard%22,%22checked%22:0},{%22value%22:%22AMEX%22,%22checked%22:0},{%22value%22:%22Discover%22,%22checked%22:0}%93″ min_length=”3″ max_length=”4″ allowed_symbols=”numbers” required_mark=”on” conditional_logic=”on” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22authorize_billing%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”CardZipCode11″ field_title=”Cardholder ZIP Code (from credit card billing address)” field_type=”input” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22Visa%22,%22checked%22:0},{%22value%22:%22MasterCard%22,%22checked%22:0},{%22value%22:%22AMEX%22,%22checked%22:0},{%22value%22:%22Discover%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”numbers” required_mark=”on” conditional_logic=”on” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22authorize_billing%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”off” form_field_font=”|700|||||||” form_field_text_color=”#000000″ /][et_pb_contact_field _builder_version=”3.0.89″ field_id=”Consent1″ field_title=”I have read the above agreement and by checking the box below agree to the terms and conditions” field_type=”checkbox” checkbox_checked=”off” checkbox_options=”%91{%22value%22:%22I accept the terms of membership as detailed below%22,%22checked%22:0}%93″ radio_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ select_options=”%91{%22value%22:%22%22,%22checked%22:0}%93″ min_length=”0″ max_length=”0″ allowed_symbols=”all” required_mark=”on” conditional_logic=”off” conditional_logic_relation=”off” conditional_logic_rules=”%91{%22field%22:%22lastname1%22,%22condition%22:%22is%22,%22value%22:%22%22}%93″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off” fullwidth_field=”on” form_field_font=”|700|||||||” form_field_text_shadow_horizontal_length=”0em” form_field_text_shadow_vertical_length=”0.1em” form_field_text_shadow_blur_strength=”0.1em” border_radii=”on|15px|15px|15px|15px” form_field_text_color=”#000000″ /] [/et_pb_contact_form][et_pb_image _builder_version=”3.0.89″ src=”https://pilotphotog.com/wp-content/uploads/2017/12/Agreement-1.png” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” always_center_on_mobile=”on” force_fullwidth=”on” show_bottom_space=”off” align=”center” /][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section bb_built=”1″ fullwidth=”off” specialty=”off” _builder_version=”3.0.89″ background_color=”#000000″ global_module=”107″][et_pb_row global_parent=”107″][et_pb_column type=”1_3″][et_pb_text global_parent=”107″ _builder_version=”3.0.89″ background_layout=”light”]

Navigation

[/et_pb_text][/et_pb_column][et_pb_column type=”1_3″][et_pb_text global_parent=”107″ _builder_version=”3.0.89″ background_layout=”light”]

Contact

e: info@pilotphotog.com

Located in Sunny Central Florida, I love to travel and if you like to setup a shoot with your airplane just let me know!

[/et_pb_text][et_pb_social_media_follow global_parent=”107″ _builder_version=”3.0.89″ url_new_window=”off” follow_button=”off” background_layout=”light” text_orientation=”center”]

[et_pb_social_media_follow_network _builder_version=”3.0.89″ social_network=”facebook” skype_action=”call” url=”https://www.facebook.com/pilotphotog/” background_color=”#3b5998″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off”] Facebook [/et_pb_social_media_follow_network][et_pb_social_media_follow_network _builder_version=”3.0.89″ social_network=”instagram” skype_action=”call” url=”https://www.instagram.com/pilotphotog/” background_color=”#517fa4″ use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off”] Instagram [/et_pb_social_media_follow_network][et_pb_social_media_follow_network _builder_version=”3.0.89″ social_network=”twitter” skype_action=”call” url=”https://twitter.com/pilotphotog” background_color=”#00aced” use_background_color_gradient=”off” background_color_gradient_start=”#2b87da” background_color_gradient_end=”#29c4a9″ background_color_gradient_type=”linear” background_color_gradient_direction=”180deg” background_color_gradient_direction_radial=”center” background_color_gradient_start_position=”0%” background_color_gradient_end_position=”100%” background_color_gradient_overlays_image=”off” parallax=”off” parallax_method=”on” background_size=”cover” background_position=”center” background_repeat=”no-repeat” background_blend=”normal” allow_player_pause=”off”] Twitter [/et_pb_social_media_follow_network]

[/et_pb_social_media_follow][/et_pb_column][et_pb_column type=”1_3″][et_pb_image global_parent=”107″ _builder_version=”3.0.89″ src=”https://pilotphotog.com/wp-content/uploads/2017/11/PPLogoWhite.png” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” align=”center” always_center_on_mobile=”on” force_fullwidth=”off” show_bottom_space=”on” /][/et_pb_column][/et_pb_row][/et_pb_section]