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2. Title II Compliance
   In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.
6. First Name*
7. Last Name*
9. Street Address*
11. City*
12. State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
13. Zip Code*
15. Phone Number*
16. Tail Number
18. Aircraft Information
20. Aircraft Co-Owners
22. First Name*
23. Last Name*
25. Address*
27. First Name
28. Last Name
30. Address
32. Hangar Preference*

    Check boxes for acceptable rows - (rates effective 9/1/2020)

    1. A_$190 - $222 (no electricity)
    2. B_$190 - $236 (no electricity)
    3. C_$190 - $236 (electricity varies)
    4. D_$190 - $236
    5. E_$297
    6. F_$297
    7. G_$297-$349

    1. H_$297-$349
    2. I_$503
    3. J_$297
    4. K_$349-$424
    5. L_$297
    6. Other
    7. Check here if you feel that all rows may be acceptable
33. Other Hangar Preference*
35. Acknowledgement for rental charges*

    1. I understand that charges for hangars are subject to change. Rent is higher for end units and A-D Row units with electricity.
37. Acknowledgement for Deposit*

    1. A $100 deposit ($10 of which is non-refundable administrative fee), must be mailed or delivered to our office before application is considered complete.
39. Modesto City-County Airport contact information
    617 Airport Way, Modesto, CA, 95354. Phone number, 209-577-5305, Fax number, 209-576-1985
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41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit Submit and Print

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