FIT Aviation Pilot Information and Aircraft Rental Agreement Credit Card Authorization Minor Parental Consent Agreement Pilot Medical Requirements Acknowledgement Insurance Pilot History Form Pilot Certificate and Logbook Records Attachment Form FAA Certified Aviation School Updated 9 February 2010 801 Harry Goode Way Melbourne, FL 32904 (321)-674-6521- (888)-259-6436 Page 1 of 11
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Aircraft Rental and Retail Training Programs Welcome! We are glad you selected FIT Aviation for your Flight Training and rental. The FIT Aviation training fleet is available for rental by qualified individuals who meet our minimum rental time requirements. For your first appointment, please have all of this material completed in order to avoid delays on your first visit. Checkout Policy All renters must take a check-flight with an FIT Aviation CFI on an annual basis. Special authorization is required for VFR night and IFR flying privileges-please see the Standard Operating Procedures and Safety Manual for more information. Anyone who has not flown in the previous 90 days will be required to do a check-out. FIT Aviation instructors will ensure that pilots are trained to proficiency prior to rental. Sorry: No instruction is permitted by non FIT Aviation flight instructors in FIT Aviation aircraft. Airplane Rental Pilot Checkout This aircraft checkout familiarizes rental pilots with company policy on fixed wing operations and ensures they have complete knowledge of operations in and out of the Melbourne International Airport, Melbourne, Florida and surrounding flight areas. Before a renter operates any aircraft, the renter must receive expressed authorization from an FIT Aviation CFI. The manner of the checkout and the amount of time required for a successful check out is at the discretion of FIT Aviation and shall be conducted in accordance with prevailing FAA regulations, safety concerns, and insurance requirements. Airplane Rental Checkout Requirements If you are a proficient and current pilot familiar with the aircraft and local area, a typical aircraft checkout takes approximately 2-3 hours. The rental checkout will include a minimum of 1 hour of flight time and 1 hour of ground time. When scheduling a checkout you will be given the appropriate paperwork for the make and model airplane you wish to fly. This paperwork as well as any membership paperwork (for new members) should be completed (if possible) prior to your lesson to ensure everything can be completed in the allotted time. If you are getting an aircraft checkout in a new make or model aircraft or an aircraft that requires a high performance or complex endorsement, you may need to schedule more than one lesson. The number of lessons you will need depends on your experience and what endorsements you may need. This type of individualized instruction will be tailored to meet your specific needs and can be discussed with an individual from our staff of instructors. A typical aircraft checkout consists of: Pilot logbook review for currency, flight time, qualifications, experience, endorsements, etc. Discussion and review of aircraft checkout form, aircraft systems, local airspace and applicable FAR's New Members: Review FIT Aviation policies and procedures Pre-Flight Inspection Pre-Start, Start, Taxi, Run-Up Normal, Short Field, or Soft Field Take-Off Normal Climb Out Slow Flight Power Off and Power On Stalls Steep Turns Simulated Engine Failure Non-towered Airport Entry Full Stop, Touch and Go Landings Go-Around Ground Reference Maneuvers, as necessary Post Flight Inspection De-Brief, logbook and paperwork completion Completed Aircraft Type Exam and Instructor review (70% or better corrected to 100%) Page 3 of 11
If you are a new member of the Flying Club, upon successful completion of the aircraft checkout, the dispatch staff will set up your member account, assist you in acquiring a password for our internet based scheduling program and give you a demonstration on how to schedule your next flight. Due to the diverse nature of our fleet and for the safety of our pilots, some of our aircraft have specific flight time and ground training requirements (as shown below) in order to fly them. These flight time minimums are required by our insurance company; however, they may be waived on a case by case basis by the Director of FIT Aviation. AIRCRAFT TYPE Piper Warrior Piper Warrior (Glass)** Cessna 172SP Piper Arrow Piper Seminole Piper Seminole (Glass)** Citabria SR-22 REQUIRED EXPERIENCE FOR VFR DAY/NIGHT OPERATIONS* Private, Instructor Checkout Private, Instructor Checkout, FIT Aviation Glass Transition Course for VFR operations Private, Instructor Checkout Private Certificate, 125 TT, 25 Complex, 15 Make/Model, Complex endorsement, Instructor Checkout. Private, Instrument, Multi, 500 TT, 100 Multi, 25 Make/Model, Instructor Checkout. Private, Instrument, Multi, 500 TT, 100 Multi, 25 Make/Model, FIT Aviation Glass Transition Course for VFR operations, Instructor Checkout. Private, 500 TT, 100 Tail-wheel, 25 Make/Model, Instructor Checkout. Private, Instrument, 250 TT, Graduate of Cirrus Course, Instructor Checkout. *IFR OPERATIONS: In order to operate an FIT Aviation airplane on an IFR flight plan and/or in Instrument Meteorological Conditions (IMC), the Renter must (1) have passed an instrument proficiency check (IPC) administered by an FIT Aviation instructor within the preceding six (6) months, or (2) be accompanied by an approved instructor. * IFR OPERATIONS GLASS: In order to operate an FIT Aviation airplane on an IFR flight plan and/or in Instrument Meteorological Conditions (IMC) in the Avidyne glass instrument panel equipped airplane, the Renter must (1) have completed the FIT Aviation Glass Transition Course for IFR operations or (2) demonstrate equivalent logged experience. FALCON FLYING CLUB The objective of the Falcon Flying Club is to provide excellent well maintained aircraft at a minimum rental cost, while extending to our customers the benefits of FIT Aviation s insurance policy. The club is built upon mutual goodwill between FIT Aviation management and club members. All FIT Aviation employees are aviation enthusiasts and encourage constructive dialogue between Falcon Club Members and FIT Aviation. Come experience the exhilarating sensation of flight with FIT Aviation and let the Falcon Flying Club ease your entry into the world of aviation! As a Falcon Flying Club member you will receive several immediate benefits including: Reduced aircraft rental rates Falcon Flying Club members will enjoy an approximate 10% discount on all of our aircraft rental rates. Reduced instructor rate Falcon Flying Club members will receive a $10/hour discount on the retail hourly instruction rate. Reduced pilot shop supplies From charts and study guides to operating handbooks and headsets, Falcon Flying Club members receive a 10% discount on all FIT Aviation pilot shop supplies. Zero deductible insurance Please see your Customer Service Representative for more information on joining the club! Page 4 of 11
FIT Aviation, LLC Signed Copy Provided to Customer: Pilot Information and Rental Agreement Version 1/20/2010 Welcome to FIT Aviation, LLC, (FITA) a wholly owned subsidiary of Florida Institute of Technology operating at 801 Harry Goode Way, Melbourne, FL 32901. Please read, complete and sign this rental agreement. By your signature below, you are accepting the terms and covenants set forth herein and agree to follow all published procedural and safety rules and regulations contained in Operations Manuals, Safety Guides, and FAA regulations. US Citizen Employee Non US Citizen: Citizen of what country? Birthdate: / / Over 18 Years of age Under 18 years of age must be accompanied by a minor consent agreement signed by parents(s) NAME (Please Print) DATE ADDRESS CITY STATE ZIP CODE PHONE: Home ( ) - Work ( ) - Cell ( ) - HOME EMAIL: @ COMPANY EMAIL: @ EMPLOYER: OCCUPATION: EMERGENCY CONTACT NAME/RELATIONSHIP EMERGENCY CONTACT PHONE NUMBER ( ) - Picture ID Drivers License Copy of must be provided by insurance Regulations Renters Insurance Exp date: Insurance policy: Issued by: FAA Certificate Number: Date issued: CERTIFICATES HELD: Student Private Commercial ATP Ratings: Instrument SEL Multi-Engine Flight Instructor: Instrument Instructor: MEI ENDOREMENTS Tailwheel Complex Endorsement High Altitude Endorsement High Performance DATE OF LAST FLIGHT REVIEW TOTAL PILOT HOURS / PREVIOUS 6 MONTHS / MEDICAL CLASS DATE ISSUED MEDICAL LIMITATIONS (IF NONE, STATE NONE ) TOTAL FLIGHT TIME IN AIRCRAFT TO BE CHECKED OUT IN AVAILABILITY FOR CHECKOUT: Check all that apply: Mon Tues Wed Thurs Friday Sat Sun AIRCRAFT CHECKED OUT IN: RENTAL CHECK OUT IP SIGNATURE: DATE CHECKED OUT: (Required for Rental Checkout) C172 SP PA28-161(conventional) PA28-161 (glass) PA28R-201 PA44-180 Citabria SR-22 Remos GX Page 5 of 11
Aircraft Rental Agreement 1. I personally warrant and represent that all information contained herein is true and I hereby agree to the following terms and covenants. 2. While operating any aircraft rented or leased to me by FIT Aviation, I agree to follow and obey all Federal Aviation Regulations set forth in parts 61 and 91, including, but not limited to, Weather, Currency, Preflight, Student Solo, Night, IFR, and Flight Review requirements and any safety requirements designated by the Chief Pilot. 3. I acknowledge that I have received a copy of the FIT Aviation Flight Operations manual and agree to follow and obey all rules and regulations established by FIT Aviation concerning the rental or lease of any aircraft hereunder, published on FIT Aviation s website and/or in other FIT Aviation written communication media and incorporated herein by this reference. I warrant and represent that I have been provided with a copy of these rules and regulations and that I have read and understand them. 4. I agree to indemnify FIT Aviation for, and hold FIT Aviation harmless from, any and all damage, loss, harm, cost, including court costs, and expense, including reasonable attorney fees, arising out of, or resulting from, my negligence, gross negligence, unlawful conduct or fraud while renting, leasing or operating any Aircraft provided to me by FIT Aviation. In addition if my account becomes delinquent and my debt is not satisfied with in 30 days of final invoice I understand that FIT Aviation will attempt to collect that debt at my expense which includes any and all collection fees, and court costs including any reasonable attorney fees. 5. I understand that I may obtain, provide a copy of the binder sheet, and keep current non-owned Renter Insurance through any aviation insurance provider to cover me for this deductible and other financial risk. I hereby authorize FIT Aviation to initiate a claim against said renters insurance policy or to file a charge against any credit card used by me at this business to cover the deductibles for aircraft damages incurred while an aircraft was under my control until insurance coverage can be verified >>>>>>> Renter s Initials <<<<<< a. Deductibles for any accident, incident or loss involving pilot error and/or violation of Federal Aviation Regulations or Rental Agreement. Renter acknowledges the following insurance coverage: $1,000,000.00 Combined Single Limit Liability Hull: $5,000.00 deductible for in motion/not in motion b. Renters are encouraged to consider purchasing an Aircraft Renters Insurance Policy to protect themselves in situations where they may be found to be responsible for damages or requiring higher coverage. In the event the Renter has purchased insurance coverage for any aircraft loss: Renter s Coverage will be primary FIT Aviation, LLC s coverage will be secondary c. For the full costs of all damages or loss resulting from breach of this rental agreement, from operations contrary to the F.A.R., Airplane Flight Manual, and FIT Aviation, LLC Renters Operating Manual, or from any action which would invalidate or reduce the insurance coverage of FIT Aviation, LLC. d. Reasonable attorney s fees incurred by FIT Aviation, LLC in the event suit is instituted to recover possession or to enforce any of these covenants and conditions hereof, or to collect any sum of money, damages or costs. e. Via credit card information provided on this form in the event that charges are not immediately settled. 6. I understand and agree that I will pay for all service and time charges, including hourly and daily minimum usage fees, computed at the applicable rate specified in FIT Aviation, LLC s current Rate Schedule. Payment will be made promptly at the end of the flight. Minimum aircraft rental charges may apply. I also agree to pay for the following expenses related to my operation of any FIT Aviation aircraft while in my possession: tie down or hangar fees, landing fees, lodging, food costs and other personal costs related to my travel. I also agree to pay any per day or flight minimums for extended use of FIT Aviation Aircraft. 7. I understand that FIT Aviation shall reimburse me for the fuel and oil that I must purchase while any FIT Aviation aircraft is in my possession. However, I understand and agree that said reimbursement shall be made by a rate, established and published by FIT Aviation, per gallon of fuel and/or quarts of oil so purchased by me according to written receipts for said purchases that I provide to FIT Aviation. 8. I understand that FIT Aviation shall reimburse me for any emergency repairs or service to the aircraft while in my possession; provided that such repair or service is not caused by my negligence, gross negligence or unlawful conduct. 9. I personally agree to pay to FIT Aviation all rental fees and taxes according to a schedule established and published by FIT Aviation. Said fees and taxes are due and payable at the conclusion of each flight when I return possession of the aircraft to FIT Aviation. Overnight or extended trips will require a 50% deposit at the time of scheduling. I agree to make payment by cash, check, credit card or credit card number on file. I understand that I may place funds on account with FIT Aviation according to terms established and published by FIT Aviation to make said payments. I also understand that FIT Aviation may charge my credit card to satisfy any balance on my account without further authorization from me. 10. At no time, will I permit or allow any other person to operate nor will I instruct any person in any aircraft rented or leased to me by FIT Aviation, without express written authorization from FIT Aviation. 11. I agree that I will not conduct any commercial operation in aircraft rented or leased to me by FIT Aviation 12. If FIT Aviation employs the services of an Attorney or a collection agency due to my breach of any of these terms and covenants, I agree to pay all costs related to said breach, including reasonable attorney fees, collection fees, and court costs. I also acknowledge that FIT Aviation will charge my account 1.5% per month for outstanding balances that remain unsettled after 30 days from incurring any charges. Accounts over 60 days old are subject to administration charges and will be added to the total in addition to previous fees. Signed by: Date: Customer/Student signature Accepted by: Date: School Official signature --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Customer Service Representative: Provided with Flight Operations Manual Customer Initials: Flight Instructor Assigned Source: Customer Referral Employee Referral Website MAPA College of Aero Gift Certificate Other Page 6 of 11
Credit Card Authorization Form Credit Card Type: Visa MasterCard American Express Panther Card CREDIT CARD NUMBER: EXP: COMPANY NAME: CARD HOLDER NAME: BILLING ADDRESS: CITY/STATE/ZIP: PHONE: Fax: Email: I,, hereby authorize FIT Aviation, LLC to automatically satisfy any outstanding account charges charged by me and not satisfied by the close of the business day of the transaction. I am aware that I will receive a copy of the charge slip and that this slip will act as my record of this transaction. This authorization will remain in effect without expiration until I rescind such authorization in writing. I understand that rescinding my authorization may affect my account privileges at FIT Aviation. Sign: Date: Page 7 of 11
Minor Consent Authorization Form (For all renters or students under the age of 18) Date: Consent and Authorization of Minor Child to Participate in and Receive Flight Training, Ground Training, Ground School Lessons and Other Airport Activities, and To Occupy and Operate Aircraft We,, and, the parent(s) and natural, or authorized non-parental guardian(s) of, a minor child (the Student ), hereby authorize the Student to participate in flight training, ground training, ground school lessons and other airport activities at FIT Aviation, LLC at Melbourne Airport and at airports and in airport facilities other than Melbourne Airport as required from time to time in the course of such training and instruction. We understand that such instruction involves flight and flight training in aircraft either under dual instruction in the physical presence of an authorized flight instructor, or in solo flight in the proximity of or away from Melbourne Airport. We understand that flight and flight instruction in aircraft involves hazards and risks not encountered by the general public in non-flight-related activities, and being aware of those hazards and risks and with knowledge of the possibility of injury or death of the Student by participating in these activities, do hereby jointly and severally consent to the Student s participation in these activities, and we hereby assume full responsibility for damages for bodily injury or death of the Student, and we, for ourselves and for the Student, and for our heirs, personal representatives, and assigns, hereby agree that FIT Aviation, LLC, and its owners, officers, members, agents, and employees shall not be liable for any damages arising from personal injury or death sustained by the Student or by us or either of us in the course of Student s flight or flight instruction activities or in the course of Student s participation in the activities described herein, and we do hereby fully and forever release and discharge FIT Aviation, LLC and its owners, officers, members, agents, employees, successors or assigns, from any and all claims, demands, damages, rights of action or causes of action, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of Student s participation in the activities described above, and whether or not the damages and injuries suffered arise in any way or in consequence of the negligence of FIT Aviation, LLC, its owners, officers, members, agents, employees, successors or assigns. We jointly and severally agree to all of the terms and conditions of the Aircraft Rental Agreement ( Agreement ) attached hereto and incorporated herein by this reference, and we agree to be bound by all of its terms and conditions, including, but not limited to, financial responsibility for the flight and ground activities in which the Student may be enrolled from time to time, and we agree to review of all of the Agreement s terms and conditions with the Student. We also agree that in consideration of FIT Aviation, LLC s obligations under the Agreement, we jointly and severally guarantee the financial obligations of the Student as set forth in the Agreement, which guarantee is a guarantee of performance and not merely a guarantee of payment as a surety. Parent/Guardian s Signature CONTACT INFORMATION Date ADDRESS CITY, STATE, ZIP PHONE NUMBER EMAIL ADDRESS Page 8 of 11
Pilot Medical Certificate Operation Acknowledgement Agreement Date: I,, hereby acknowledge that I have read and understand FAA CFR 61.23(c) regulation pertaining to the medical certificate requirements for the operation of Light Sport Aircraft. I understand that any other operation of any other aircraft owned or operated by FIT Aviation will require that I possess an FAA Medical Certificate duly issued by an FAA Aero Medical Examiner (AME). I agree to carry a valid driver s license as required by law and to comply with any restrictions or limitations imposed by that license as it applies to the operation of a motor vehicle. I further understand that by agreeing to this the terms of this document, I am certifying that I now am in good health, mind and spirit, and that I am not suffering from any acute or chronic condition or ailment that would preclude the safe operation of an aircraft. I also am certifying that I have never been denied an FAA Medical certificate which would restrict my operation of any Light sport aircraft without a pilot medical certificate. I finally agree that if any such condition, illness, ailment, or diagnosis were to occur that I would cease flying immediately and consult an FAA Aero Medical Examiner (AME) for the purposes of determining my suitability for the operation of an aircraft. Pilot s Name and Signature Date Contact Information Address City, State, Zip Phone Number Email Address CFR 61.23 as of 01/19/2010 (c) Operations requiring either a medical certificate or U.S. driver's license. (1) A person must hold and possess either a medical certificate issued under part 67 of this chapter or a U.S. driver's license when exercising the privileges of (i) A student pilot certificate while seeking sport pilot privileges in a light-sport aircraft other than a glider or balloon; (ii) A sport pilot certificate in a light-sport aircraft other than a glider or balloon; or (iii) A flight instructor certificate with a sport pilot rating while acting as pilot in command or serving as a required flight crewmember of a light-sport aircraft other than a glider or balloon. (2) A person using a U.S. driver's license to meet the requirements of this paragraph must (i) Comply with each restriction and limitation imposed by that person's U.S. driver's license and any judicial or administrative order applying to the operation of a motor vehicle; (ii) Have been found eligible for the issuance of at least a third-class airman medical certificate at the time of his or her most recent application (if the person has applied for a medical certificate); (iii) Not have had his or her most recently issued medical certificate (if the person has held a medical certificate) suspended or revoked or most recent Authorization for a Special Issuance of a Medical Certificate withdrawn; and (iv) Not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner. Page 9 of 11
FIT AVIATION INSURANCE PILOT HISTORY FORM NAME OF AIRCRAFT OWNER OR NAME OF INSURED PILOT S FULL NAME DATE OF BIRTH PILOT S ADDRESS (STREET) (CITY) (STATE/PROVINCE) (ZIP/POSTAL CODE) EMPLOYMENT HISTORY EMPLOYER Current Employer 1. 2. 3. 4. DATES EMPLOYED OCCUPATION. If employed as a pilot, list all duties in addition to those normal for a pilot and indicate percentage of your total time spent on non-pilot related duties. DRIVERS LICENSE NO. STATE/PROVINCE AIRMAN S CERTIFICATE NO. CERTIFICATES / ENDORSEMENTS AND RATINGS Student Single Engine Land Private Single Engine Sea Commercial Seaplane * Sr. Commercial Multi Engine Land Airline (ATP)/(ATR) Multi Engine Sea Instructor Center Line Thrust * Class Helicopter Instrument Rating Glider * Class Mechanic Aircraft *Night Mechanic Powerplant Other (Specify): Type Ratings / Endorsements (Specify): MEDICAL CLASS AND DATE OF EXPIRATION CIVILIAN -TOTAL HOURS LOGGED PISTON TURBO AIRCRAFT LAND SEA AMPH. PROP. SINGLE ENG Fixed Wing MULTI ENG Fixed Wing Rotary Wing MILITARY - TOTAL HOURS LOGGED AIRCRAFT PISTON TURBO PROP. JET Fixed Wing Rotary Wing DATE OF LAST BIENNIAL OR ANNUAL FLIGHT REVIEW JET LIST MAKE AND MODEL (One per line must include Make and Model aircraft being insured) BREAKDOWN OF EXPERIENCE BY MAKE AND MODEL (Please specify makes and models and whether land, sea, or amphibian) TOTAL LOGGED HOURS Total Hours Last 90 Days VFR Last 12 months IFR Last 12 months TIME AS SECOND-IN-COMMAND (Co-Pilot) Total Hours Last 90 days VFR Last 12 months IFR Last 12 months TOTAL LOGGED HOURS FOR TAILWHEEL EQUIPPED AIRCRAFT: TOTAL PILOT-IN-COMMAND HOURS OF ALL MULTI ENGINE AIRCRAFT: APPROXIMATE NUMBER OF WATER LANDINGS AND TAKE-OFFS MADE DURING THE LAST 12 MONTHS: SPECIFY MAKE AND MODEL (S) ON WHICH APPROVAL IS SOUGHT AS PILOT IN COMMAND SECOND IN COMMAND WHERE AND WHEN DID YOU LEARN TO FLY? (Give year, place and school or course completed) List Manufacturer s Approved, Initial Ground & Flight Schools And Dates Attended (Specify by Model) SCHOOL MODEL DATES If you are not currently enrolled in a recurrent Flight Training Program, please complete this section only with respect to your most recent Flight Proficiency Check Flight in the Insured Aircraft Make and Model. WAS IT VFR IFR DATE Page 10 of 11
NAME OF FACILITY PROVIDING PROFICIENCY CHECK FLIGHT Are you or your Company enrolled in any recurrent Flight Training Program? No Yes If Yes, specify make and model aircraft, the facility affording the training, their location and number of recurrent training programs completed annually by you 1. Do you have any physical impairments or do you have any waivers, limitations or conditions attached to your Medical Certificate? 1a. Do you have any other medical conditions that could affect your ability to safely pilot or crew an aircraft? If YES, please give details: 2. Has your FAA or DOT or Military Pilot Certificate ever been suspended or revoked? PLEASE EXPLAIN EACH YES ANSWER 3. Have you ever been cited for any violations of Federal or Canadian Air Regulations or any license limitations? 4. Arising out of the operation of a motor vehicle, have you ever had your driver s license suspended or revoked? 5. Have you ever been convicted of or pleaded guilty to a (A) charge of reckless driving or driving under the influence of alcohol or drugs? OR (B) a felony? 6. Have you ever had an application for aircraft hull or liability insurance declined by an insurance company? 7. Have you had any aircraft accidents / incidents while acting as Pilot? If YES, give dates, places, make and model of aircraft, TAIL NUMBER of aircraft, and details of accident(s): 8. Have you filed any aviation claims in the last three years? If YES, give dates and brief summary of circumstances: 9. Do you give us permission to request your pilot record, medical history, and request information about your piloting record in accordance with the Freedom of Information Act? As a normal part of the Company s underwriting procedure a routine inquiry may be made which will include information concerning general reiteration, personal characteristics and mode of living. In the United States Public Law 91-308 (Federal Fair Credit Reporting Act) requires that if such a report is made upon your written request within a reasonable time after you receive this notice, additional information as to the nature and scope of the inquiry will be provided. You have my consent to contact pilot training facilities which I have attended for information relating to my training and I hereby expressly authorize any such pilot training facilities to release information about me. You also have my permission to obtain information about my pilot record, medical records and accident history maintained by the FAA for the purposes of determining my competency and credit worthiness of renting, using, or piloting an aircraft. I certify that the statements in this form are true to the best of my knowledge and belief. Any intentional completion of misleading or incomplete information on this form for the purposes of obtaining privileges of aircraft rental, instruction, or other services provided by this facility, company, or its employees is considered fraudulent and may lead to charges under Federal statutes. PILOT SIGNATURE: DATE: Attach scanned, color copy of all FAA Airman Certificates, medical, and valid Driver s License. Attach copy of last two pages of your pilot logbook and a copy of the endorsements page of your logbook Page 11 of 11