PIC Application

 
Personal Information
Full name:

E-mail:

Date of Birth:

Address:

City, State, and Zip:

Phone Number:
Pilot's License Number:
Type of License: (Please check boxes that apply to applicant)
COMM ATP
Ratings:
ASEL AMEL INST
CFI    CFII   CFMEI
Other Ratings:


Flight Experience
Total Fight Time

Fixed Wing Total

Total Day

Total Night

Total Cross Country

Instrument Total

Actual

Simulated (Hood)

Simulator

Multi-Engine Total

PIC

SIC

Total Instruction Given

Flight Time Last 12 Months

Last 6 months

Total Time in Aero Commander (please specify model)

Date of last FAR 135 Checkride

Commercial Flight Time since January 1, Current year
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