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AMC1 BFCL.410(b)(3) Conduct of skill tests, proficiency checks and assessments of competence

Available versions for ERULES-1963177438-16146

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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AMC1
BFCL.410(b)(3)  Conduct of skill tests, proficiency checks and
assessments of competence

ED Decision 2020/003/R

APPLICATION AND REPORT FORM FOR
THE BPL SKILL TEST OR PROFICIENCY CHECK

<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tr>
<td colspan="10" width="100%">
APPLICATION AND REPORT FORM FOR THE BPL SKILL TEST
 OR PROFICIENCY CHECK 
</td>
</tr>
<tr>
<td colspan="2" rowspan="2" width="14%">
Tick
 as applicable
</td>
<td colspan="8" valign="top" width="85%">
I
 hereby apply for the issue of the following, in accordance with Annex III
 (Part-BFCL) to Regulation (EU) 2018/395:
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</v:group>   Balloon pilot licence (BPL)
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</v:shape>
</v:group>   Commercial operation rating
</td>
</tr>
<tr>
<td colspan="8" valign="top" width="85%">
I
 hereby report the following, in accordance with Annex III (Part-BFCL) to
 Regulation (EU) 2018/395:
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</v:group>   Proficiency check (BPL — recency)
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</v:group>   Proficiency check (commercial operation
 rating)
</td>
</tr>
<tr>
<td valign="top" width="3%">
1 
</td>
<td colspan="9" valign="top" width="96%">
Applicant’s personal particulars: 
</td>
</tr>
<tr>
<td colspan="6" valign="top" width="47%">
Applicant’s
 last name(s): 
</td>
<td colspan="4" valign="top" width="52%">
First
 name(s): 
</td>
</tr>
<tr>
<td colspan="5" valign="top" width="33%">
Date
 of birth: 
</td>
<td colspan="3" valign="top" width="33%">
Telephone:
 
</td>
<td colspan="2" valign="top" width="33%">
Email:
 
</td>
</tr>
<tr>
<td colspan="6" valign="top" width="47%">
Address:
 
</td>
<td colspan="4" valign="top" width="52%">
Country:
 
</td>
</tr>
<tr>
<td colspan="6" valign="top" width="47%">
Date:
</td>
<td colspan="4" valign="top" width="52%">
Signature:
</td>
</tr>
<tr>
<td valign="top" width="3%">
2 
</td>
<td colspan="9" valign="top" width="96%">
Licence details 
</td>
</tr>
<tr>
<td colspan="10" valign="top" width="100%">
Licence
 number (if applicable): 
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="27%">
Class
 extension(s): 
(tick as applicable)
</td>
<td colspan="6" valign="top" width="72%">
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</v:group>   Hot-air airships
</td>
</tr>
<tr>
<td colspan="10" valign="top" width="100%">
FROM HERE TO BE COMPLETED BY THE EXAMINER
</td>
</tr>
<tr>
<td valign="top" width="3%">
3 
</td>
<td colspan="9" valign="top" width="96%">
Details of the skill test/proficiency check flight 
</td>
</tr>
<tr>
<td colspan="5" valign="top" width="33%">
Date:
</td>
<td colspan="3" width="33%">
Class/group
 of balloon:
</td>
<td colspan="2" valign="top" width="33%">
Registration:
</td>
</tr>
<tr>
<td colspan="3" width="25%">
Take-off
 site:
</td>
<td colspan="4" width="25%">
Take-off
 time:
</td>
<td colspan="2" width="25%">
Landing
 time:
</td>
<td width="25%">
Flight
 time:
</td>
</tr>
<tr>
<td colspan="2" width="25%">
</td>
<td width="25%">
</td>
</tr>
<tr>
<td colspan="2" width="25%">
</td>
<td width="25%">
</td>
</tr>
<tr>
<td colspan="2" width="25%">
</td>
<td width="25%">
</td>
</tr>
<tr>
<td colspan="2" width="25%">
</td>
<td width="25%">
</td>
</tr>
<tr>
<td colspan="9" width="75%">
  
 Total flight time:
</td>
</tr>
<tr>
<td valign="top" width="3%">
4 
</td>
<td colspan="9" valign="top" width="96%">
Result of the test or check  
</td>
</tr>
<tr>
<td colspan="10" valign="top" width="100%">
Skill
 test/proficiency check details (including information on oral theoretical
 knowledge examination, where applicable):
</td>
</tr>
<tr>
<td colspan="5" width="33%">
Passed  <v:group coordsize="94488,94488" id="Group_x0020_7" o:gfxdata="UEsDBBQABgAIAAAAIQC2gziS/gAAAOEBAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbJSRQU7DMBBF
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</td>
<td colspan="3" width="33%">
Partially
 passed  <v:group coordsize="94488,94488" id="Group_x0020_9" o:gfxdata="UEsDBBQABgAIAAAAIQC2gziS/gAAAOEBAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbJSRQU7DMBBF
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</v:shape>
</v:group> 
</td>
<td colspan="2" width="33%">
Failed  <v:group coordsize="94488,94488" id="Group_x0020_11" o:gfxdata="UEsDBBQABgAIAAAAIQC2gziS/gAAAOEBAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbJSRQU7DMBBF
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</tr>
<tr>
<td valign="top" width="3%">
5 
</td>
<td colspan="9" valign="top" width="96%">
Remarks 
</td>
</tr>
<tr>
<td colspan="10" valign="top" width="100%">
Reasons
 and details in case of fail or partial pass/other remarks as necessary:
</td>
</tr>
<tr>
<td valign="top" width="3%">
6 
</td>
<td colspan="9" valign="top" width="96%">
Examiner’s declarations and details
</td>
</tr>
<tr>
<td colspan="10" valign="top" 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 or partial pass; 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="7" valign="top" width="50%">
Examiner’s
 certificate number:
</td>
<td colspan="3" valign="top" width="50%">
Examiner’s
 BPL number:
</td>
</tr>
<tr>
<td colspan="7" valign="top" width="50%">
Examiner’s
 name (capital letters):
</td>
<td colspan="3" valign="top" width="50%">
Date
 and examiner’s signature:
</td>
</tr>
<tr>
<td valign="top" width="3%">
7 
</td>
<td colspan="9" valign="top" width="96%">
Attachments
</td>
</tr>
<tr>
<td colspan="10" valign="top" width="100%">
Detailed report of skill test or proficiency check
 as per AMC1 BFCL.145 or AMC1 BFCL.215 (as applicable) to be attached
</td>
</tr>
<tr>
<td colspan="10" 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>