REQUEST INFORMATION * indicates required field First Name* Last Name* Middle Initial Company Name Title Address 1* City* Zip Code* Address 2 State or Province* Country* Home Phone* Work Phone Alternate Phone Best time to call* AM PM Email Address* I would like to schedule a local demo flight. Yes No Please send me an info pack and FREE Husky Adventure DVD. Yes No How did you hear about Aviat Aircraft? Magazine Ads Website Trade/Air Show Word-of-mouth Other Would you like to take advantage of Aviat's Financing Group? Yes No Do you own an aircraft? Yes No If so, what type? Make Serial # Model Tail # What do you need assistance with? Sales Dealer Inquiry Parts Financing Remanufacture Program Other Questions or comments: Aviat Aircraft Inc. 672 S. Washington P.O. Box 1240 Afton, WY 83110 Phone: 307-885-3151 Fax: 307-885-9674 aviat@aviataircraft.com

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