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

I hereby apply for the issue of a flight instructor certificate for sailplanes (FI(S)) in accordance with Annex III (Part-SFCL) to Regulation (EU) 2018/1976.

1

Applicant’s personal particulars

Applicant’s last name(s):

First name(s):

Date of birth:

Telephone:

Email:

Address:

Country:

Date:

Signature of the applicant:

2

Licence details

Licence number (SPL):

Additional privileges:

(tick as applicable)

   TMG extension

   TMG night rating

   Advanced aerobatic privileges

   Sailplane cloud flying privileges

   Sailplane towing rating

   Banner towing rating

Launching methods:

(tick as applicable)

   Aero tow launch

   Winch launch

   Bungee launch

   Self-launch

3

Pre-course flying experience

Sailplanes

TMG

PIC hours:

Total hours:

Number of launches / take-offs:

Aero tow launch:

Winch launch:

4

Pre-entry assessment 

I recommend ..................................... for the FI(S) course.

Name of ATO/DTO:

Date of pre-entry assessment:

Name (capital letters) of HT of the ATO/DTO:

Name (capital letters), licence number and signature of the FI(S) conducting the flight assessment (if applicable):

5

Declaration by the ATO/DTO

I certify that .......................................... has satisfactorily completed an approved course of training for the FI(S) certificate 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 HT:

Signature:

Name of ATO/DTO:

FROM HERE TO BE COMPLETED BY THE EXAMINER

6

Result of the assessment of competence

Oral theoretical knowledge examination:

   Passed

   Partially passed

   Failed

Practical part:

   Passed

   Partially passed

   Failed

Reasons and details in case of fail or partial pass/other remarks as necessary:

In case of fail:

(tick as applicable)

   I recommend further ground training before retest.

   I recommend further flight training with an FI(S) before retest.

   I do not consider further flight or theoretical instruction necessary before retest.

I, the undersigning examiner:

-           have received information from the applicant regarding their experience and instruction, and found that experience and instruction comply with the applicable requirements of Annex III (Part-SFCL) to Regulation (EU) 2018/1976;

-           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.

Examiner’s certificate number:

Examiner’s SPL number:

Examiner’s name (capital letters):

Date and examiner’s signature:

7

Attachments

Detailed report as per AMC2 SFCL.345 to be attached

Copy of the FE(S) certificate (in cases where the competent authority of the applicant is different from the competent authority of the examiner)