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AMC3 BFCL.345 FI(B) - Assessment of competence

Available versions for ERULES-1963177438-16140

ED Decision 2020/003/R found in: Balloon Rule Book - Part-BOP Part-BFCL Part-ML CS-31GB CS-31HB CS-31TGB (Sep 2020)

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AMC3
BFCL.345  FI(B) – Assessment of competence

ED Decision 2020/003/R

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

<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tr>
<td colspan="14" width="100%">
APPLICATION AND REPORT FORM FOR THE FI(B)
 ASSESSMENT OF COMPETENCE 
</td>
</tr>
<tr>
<td colspan="14" width="100%">
I
 hereby apply for the issue of a flight instructor certificate for balloons
 (FI(B)) in accordance with Annex III (Part-BFCL) to Regulation (EU)
 2018/395.
</td>
</tr>
<tr>
<td valign="top" width="3%">
1 
</td>
<td colspan="13" valign="top" width="96%">
Applicant’s personal particulars: 
</td>
</tr>
<tr>
<td colspan="7" valign="top" width="47%">
Applicant’s
 last name(s): 
</td>
<td colspan="7" valign="top" width="52%">
First
 name(s): 
</td>
</tr>
<tr>
<td colspan="6" valign="top" width="33%">
Date
 of birth: 
</td>
<td colspan="5" valign="top" width="33%">
Telephone:
 
</td>
<td colspan="3" valign="top" width="33%">
Email:
 
</td>
</tr>
<tr>
<td colspan="7" valign="top" width="47%">
Address:
 
</td>
<td colspan="7" valign="top" width="52%">
Country:
 
</td>
</tr>
<tr>
<td colspan="7" valign="top" width="47%">
Date:
</td>
<td colspan="7" valign="top" width="52%">
Signature
 of the applicant:
</td>
</tr>
<tr>
<td valign="top" width="3%">
2 
</td>
<td colspan="13" valign="top" width="96%">
Licence details 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Licence
 number (BPL): 
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="27%">
Class
 extension(s): 
(tick as applicable)
</td>
<td colspan="10" valign="top" width="72%">
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</v:group>   Hot-air airships
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="27%">
Additional
 privileges: 
(tick as applicable)
</td>
<td colspan="10" valign="top" width="72%">
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</v:group>   Tethered hot-air balloon flight rating
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</v:group>   Night rating
</td>
</tr>
<tr>
<td valign="top" width="3%">
3 
</td>
<td colspan="13" valign="top" width="96%">
Pre-course flying experience 
</td>
</tr>
<tr>
<td colspan="5" width="31%">
Flying
 hours in different classes
</td>
<td colspan="5" width="22%">
Hot-air balloon
</td>
<td colspan="3" width="22%">
Gas balloon
</td>
<td width="22%">
Hot-air airship
</td>
</tr>
<tr>
<td colspan="5" width="31%">
 PIC
</td>
<td colspan="5" width="22%">
</td>
<td colspan="3" width="22%">
</td>
<td width="22%">
</td>
</tr>
<tr>
<td colspan="5" width="31%">
Total time
</td>
<td colspan="5" width="22%">
</td>
<td colspan="3" width="22%">
</td>
<td width="22%">
</td>
</tr>
<tr>
<td valign="top" width="3%">
4 
</td>
<td colspan="13" valign="top" width="96%">
Pre-entry assessment  
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
I recommend
 .....................................for the FI(B) course.
</td>
</tr>
<tr>
<td colspan="8" valign="top" width="50%">
Name
 of ATO/DTO: 
</td>
<td colspan="6" valign="top" width="50%">
Date
 of pre-entry assessment: 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Name
 (capital letters) of HT of the ATO/DTO: 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Name
 (capital letters), licence number and signature of the FI(B) conducting the
 flight assessment (if applicable): 
</td>
</tr>
<tr>
<td valign="top" width="3%">
5 
</td>
<td colspan="13" valign="top" width="96%">
Declaration by the ATO/DTO
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
I certify that
 .......................................... has satisfactorily completed an
 approved course of training for the FI(B) certificate in accordance with the
 relevant syllabus.
</td>
</tr>
<tr>
<td colspan="8" valign="top" width="50%">
Flying
 hours during the course: 
</td>
<td colspan="6" valign="top" width="50%">
Take-offs
 during the course:
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Name(s)
 of HT: 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Signature:
 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Name
 of ATO/DTO: 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
FROM HERE TO BE COMPLETED BY THE EXAMINER
</td>
</tr>
<tr>
<td valign="top" width="3%">
6 
</td>
<td colspan="13" valign="top" width="96%">
Result of the assessment of competence 
</td>
</tr>
<tr>
<td colspan="3" width="25%">
Oral
 theoretical knowledge examination:
</td>
<td colspan="6" width="25%">
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</v:group>   Passed
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Practical
 part:
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</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Reasons
 and details in case of fail or partial pass/other remarks as necessary:
</td>
</tr>
<tr>
<td colspan="2" rowspan="2" width="20%">
In
 case of fail:
(tick as applicable)
</td>
<td colspan="12" valign="top" width="79%">
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</v:group>   I recommend further ground
 training before retest.
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</v:shape>
</v:group>   I recommend further flight
 training with an FI(B) before retest.
</td>
</tr>
<tr>
<td colspan="12" valign="top" width="79%">
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</v:shape>
</v:group>   I do not consider further
 flight or theoretical instruction necessary before retest.
</td>
</tr>
<tr>
<td colspan="14" width="100%">
I, the
 undersigning examiner:
-    have
 received information from the applicant regarding their experience and
 instruction, and found that the experience and instruction comply with the
 applicable requirements of Annex III (Part-BFCL) to Regulation (EU)
 2018/395; 
-    confirm
 that all the required manoeuvres and exercises have been completed, unless
 specified otherwise above in the case of fail; and
-    where
 applicable, have reviewed and applied the national procedures and
 requirements of the applicant’s competent authority which is different from
 the competent authority that issued my examiner certificate.
</td>
</tr>
<tr>
<td colspan="8" valign="top" width="50%">
Examiner’s
 certificate number:
</td>
<td colspan="6" valign="top" width="50%">
Examiner’s
 BPL number:
</td>
</tr>
<tr>
<td colspan="8" valign="top" width="50%">
Examiner’s
 name (capital letters):
</td>
<td colspan="6" valign="top" width="50%">
Date
 and examiner’s signature:
</td>
</tr>
<tr>
<td valign="top" width="3%">
7 
</td>
<td colspan="13" valign="top" width="96%">
Attachments 
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Detailed report as per AMC2 BFCL.345 to be attached
</td>
</tr>
<tr>
<td colspan="14" valign="top" width="100%">
Copy of the FE(B) certificate (in cases where the
 competent authority of the applicant is different from the competent
 authority of the examiner)
</td>
</tr>
<tr height="0">
</tr>
</table>