Costello Insurance Associates Aviation Insurance

 Costello Insurance
 Associates, Inc.
 Tel: 800.528.6483
 Tel: 480.968.7746
 Fax: 480.967.3828
 insure@aviationi.com

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Personal, Pleasure and Competition Glider Insurance Needs.



Pilot 1
Pilots Name Age
Glider Certificates/Ratings (i.e Student, Private, Commerical, CFIG):
Total Glider Flights  
Total flights in glider with a glide ratio of 35-1 or better
Total Flights in each Make & Model to be Insured 1: 2: 3:
Any physical disabilities that might impact the pilots ability to operate the glider? Yes No
If yes, please describe:

Pilot 2
Pilots Name Age
Glider Certificates/Ratings (i.e Student, Private, Commerical, CFIG):
Total Glider Flights  
Total flights in glider with a glide ratio of 35-1 or better
Total Flights in each Make & Model to be Insured 1: 2: 3:
Any physical disabilities that might impact the pilots ability to operate the glider? Yes No
If yes, please describe:

Pilot 3
Pilots Name Age
Glider Certificates/Ratings (i.e Student, Private, Commerical, CFIG):
Total Glider Flights  
Total flights in glider with a glide ratio of 35-1 or better
Total Flights in each Make & Model to be Insured 1: 2: 3:
Any physical disabilities that might impact the pilots ability to operate the glider? Yes No
If yes, please describe:
Thank you for taking the time to complete this form.