AircraftPortal.com Piston Powered Aircraft
Photo Enhanced Advertisement Submission Form.
Payment methods and totals are listed at the end of this
form.
Important Note...
Please print this form and fill in the required information.
Please print clearly for all responses. Mail/fax using the
following information.
AircraftPortal.com
3336 Associates Drive
Burton, Michigan 48529-1302
810-232-9979 Phone
810-232-7177 Fax
866-232-9979 Toll Free Phone
866-232-7177 Toll Free Fax
Required Information (*)
- Aircraft Company/Owner Information
First Name (*): _______________________________
Last Name (*): _______________________________
Company Name: _______________________________
Address (*): _______________________________
_______________________________
City (*): _______________________________
State/Location (*): _______________________________
Zip (*): _______________________________
Phone Number - Day (*): _______________________________
Phone Number - Evenings: _______________________________
Optional Phone Number: _______________________________
Fax Number: _______________________________
Cellular Number: _______________________________
Pager Number: _______________________________
E-mail Address - One: _______________________________
E-mail Address - Two: _______________________________
(Home Page Link is required for
External Link Address)
Home Page Link: _______________________________
- Aircraft Overview and Summary Data
Aircraft Manufacturer
and Type/Description(*): _______________________________
Aircraft Year: _______________________________
Aircraft Registration Number: _______________________________
Aircraft Serial Number: _______________________________
Aircraft Total Time: _______________________________
Location of Aircraft: _______________________________
Asking Price: _______________________________
Last Annual Inspection: _______________________________
- Aircraft Engine and Propeller Times
Engine Total Time (TT) - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
Engine Total Time STOH - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
Engine Total Time SMOH - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
Propeller Time SPOH - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
- Exterior/Interior Colors/Appointments
Exterior Color: _______________________________
Exterior Trim One: _______________________________
Exterior Trim Two: _______________________________
Exterior Trim Three: _______________________________
Exterior Other One: _______________________________
Exterior Other Two: _______________________________
Interior Overview: _______________________________
Interior Color One: _______________________________
Interior Color Two: _______________________________
Interior Color Three: _______________________________
Interior Other One: _______________________________
Interior Other Two: _______________________________
- Avionics
Avionics Overview - One: _______________________________
Avionics Overview - Two: _______________________________
Audio Panel: _______________________________
Autopilot: _______________________________
Nav/Comm 1: _______________________________
Nav/Comm 2: _______________________________
Weather Protection: _______________________________
GPS: _______________________________
Transponder: _______________________________
Description 1: _______________________________
Description 2: _______________________________
Description 3: _______________________________
Description 4: _______________________________
Description 5: _______________________________
- Optional Equipment and Accessories
Option - #1: _______________________________
Option - #2: _______________________________
Option - #3: _______________________________
Option - #4: _______________________________
Option - #5: _______________________________
Option - #6: _______________________________
Option - #7: _______________________________
Option - #8: _______________________________
Option - #9: _______________________________
Option - #10: _______________________________
Option - #11: _______________________________
Option - #12: _______________________________
- Notes of Interest (Maximum length is 725 characters - includes all
characters and spaces).
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Aircraft Highlights and Feature Color (Circle one)
1.)Green 2.)Blue 3.)Yellow
Background/Display (Circle one)
1.)Clouds 2.)IFR Chart 3.)VFR Chart
Please mail any required photo(s)(feature up to 6) to the address above.
Clearly mark on the back of each photo your name and aircraft
registration number. All photo(s) become the property of
AircraftPortal.com unless a self addressed stamped envelope is included
for return.
- Any additional information we should have to process this ad?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Sixty (60) Day Run Time...
Photo Enhanced Piston Powered Advertisement: $ 14.95
________
Total Enclosed $
- Payment Method (please mark the appropriate selection)
Check: _____ (see note below)
Money Order: _____
MasterCard: _____ Card Number: ______________________ Exp. Date: _____
Name on Card: _________________________________
Credit Card Authorization Signature: _________________________________
(Please charge my credit card the
total listed above)
Visa: _____ Card Number: ______________________ Exp. Date: _____
Name on Card: _________________________________
Credit Card Authorization Signature: _________________________________
(Please charge my credit card the
total listed above)
Important Note:
Advertisements will not be viewable until payment has cleared.
Select your browsers back button to return to the previous page.