APPLICATION AND REPORT FORM FOR THE INSTRUCTOR ASSESSMENT OF COMPETENCE

1

Applicants personal particulars:

Applicant’s last name(s):

First name(s):

Date of birth:

Tel (home):

Tel (work):

Address:

Country:

2

Licence details

Licence type:

Number:

Class ratings included in the licence:

Exp. Date:

Type ratings included in the licence:

1.

2.

3.

4.

5.

Other ratings included in the licence:

1.

2.

3.

4.

5.

3

Pre-course flying experience

Total flying

hours

PIC       

SEP or TMG

hours

SEP preceding 6 months

Instrument flight instruction

Cross-country hours

4

Pre-entry flight test 

I recommend .....................................for the FI course.

Name of ATO:

Date of flight test:

Name(s) of FI conducting the test (capital letters):

Licence number:

Signature:

5

Declaration by the applicant

I have received a course of training in accordance with the syllabus for the:  (tick as applicable)

FI certificate FI(A)/(H)/(As)

IRI certificate IRI(A)/(H)/(As)

CRI certificate CRI(A)

Applicant’s name(s):

(capital letters)

Signature:

6

Declaration by the CFI

I certify that .......................................... has satisfactorily completed an approved course of training for the

FI certificate FI(A)/(H)/(As)

IRI certificate IRI(A)/(H)/(As)

CRI certificate CRI(A)

in accordance with the relevant syllabus.

Flying hours during the course:

Aircraft or FSTDs used :

Name(s) of CFI:

Signature:

Name of ATO:

7

Flight instructor examiner’s certificate

I have tested the applicant according to to Part-FCL

A. FLIGHT INSTRUCTOR EXAMINER’S ASSESSMENT (in case of partial pass):

Theoretical oral examination:

Skill test:

Passed

Failed

Passed

Failed

I recommend further flight or ground training with an instructor before re-test

I do not consider further flight or theoretical instruction necessary before re-test  (tick as applicable)

B. FLIGHT INSTRUCTOR EXAMINER’S ASSESSMENT:

FI certificate

IRI certificate

CRI certificate

(tick as applicable)

Name(s) of FIE (capital letters):

Signature:

Licence number:

Date:

APPLICATION AND REPORT FORM FOR THE FI(S) ASSESSMENT OF COMPETENCE

1

Applicants personal particulars:

Applicant’s last name(s):

First name(s):

Date of birth:

Tel (home):

Tel (work):

Address:

Country:

2

Licence details

Licence type:

Number:

TMG extension:

3

Pre-course flying experience

Total flying hours

PIC hours

Sailplane (PIC hours and take-offs)

TMG (PIC hours and take-offs)

4

Pre-entry flight test 

I recommend .....................................for the FI course.

Name of ATO:

Date of flight test:

Name(s) of FI conducting the test (capital letters):

Licence number:

Signature:

5

Declaration by the applicant

I have received a course of training in accordance with the syllabus for the:

FI certificate FI(S)

Applicant’s name(s):

(capital letters)

Signature:

6

Declaration by the chief flight instructor

I certify that .......................................... has satisfactorily completed an approved course of training for the

FI certificate FI(S)

in accordance with the relevant syllabus.

Flying hours during the course:

Take-offs during the course:

Sailplanes, powered sailplanes or TMGs used :

Name(s) of CFI:

Signature:

Name of DTO or ATO:

7

Flight instructor examiner’s certificate

I have tested the applicant according to Part-FCL

A. FLIGHT INSTRUCTOR EXAMINER’S ASSESSMENT (in case of partial pass):

Theoretical oral examination:

Skill test:

Passed

Failed

Passed

Failed

I recommend further flight or ground training with an instructor before re-test

I do not consider further flight or theoretical instruction necessary before re-test  (tick as applicable)

B. FLIGHT INSTRUCTOR EXAMINER’S ASSESSMENT:

FI certificate

Date:

Name(s) of FIE (capital letters):

Signature:

Licence number:

Date:

APPLICATION AND REPORT FORM FOR THE FI(B) ASSESSMENT OF COMPETENCE

1

Applicants personal particulars:

Applicant’s last name(s):

First name(s):

Date of birth:

Tel (home):

Tel (work):

Address:

Country:

2

Licence details

Licence type:

Number:

Class extension:

1.

Groups:

2.

Groups:

3.

Groups:

3

Pre-course flying experience

Total flying hours in different groups

PIC hours

Hot-air balloon

Gas balloon

Hot-air airship

4

Pre-entry flight test 

I recommend .....................................for the FI course.

Name of ATO:

Date of flight test:

Name(s) of FI conducting the test (capital letters):

Licence number:

Signature:

5

Declaration by the applicant

I have received a course of training in accordance with the syllabus for the:

FI certificate FI(B)

Applicant’s name(s):

(capital letters)

Signature:

6

Declaration by the chief flight instructor

I certify that .......................................... has satisfactorily completed an approved course of training for the

FI certificate FI(B)

in accordance with the relevant syllabus.

Flying hours during the course:

Take-offs during the course:

Balloons, hot-air airships used:

Name(s) of CFI:

Signature:

Name of DTO or ATO:

7

Flight instructor examiner’s certificate

I have tested the applicant according to Part-FCL

A. FLIGHT INSTRUCTOR EXAMINER’S ASSESSMENT (in case of partial pass):

Theoretical oral examination:

Skill test:

Passed

Failed

Passed

Failed

I recommend further flight or ground training with an FI before re-test

I do not consider further flight or theoretical instruction necessary before re-test  (tick as applicable)

B. FLIGHT INSTRUCTOR EXAMINER’S ASSESSMENT:

FI certificate

Name(s) of FIE (capital letters):

Signature:

Licence number:

Date: