England Airpark & Community

(AEX) Alexandria International Airport Written Agreement Application

Form intended for entities / individuals requesting to conduct business at AEX.

Name of entity requesting Airport Use Agreement: *

Address: *

Address of entity requesting Airport Written Agreement

State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zipcode: *

Type of Use Agreement requested: *

Lease

Sublease

User Permit

Emergency Use Permit

Description of commercial activity to be performed on airport: *

Qualifications to perform commercial activity on airport: *

Name of person requesting Airport Written Agreement: *

Address: *

Address of person requesting Airport Written Agreement

State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zipcode: *

Telephone: *

Email: *

Position of person requesting Airport Written Agreement: *

Requested term of Airport Written Agreement: *

Do you presently hold satisfactory insurance to perform this service: *

Yes

No

Are you willing to provide information to conduct required security background checks for all employees accessing Airport Operating Area (AOA): *

Yes

No

Word verification: * (verify using audio)

Type the characters you see in the picture above; if you can't read them, submit the form and a new image will be generated. Not case sensitive.