1/6 APPLICATION FOR PILOT EXAM Male Female Application for

1/6 APPLICATION FOR PILOT EXAM Male Female Application for

APPLICATION FOR PILOT EXAM
PART 1 – APPLICANT DETAILS
APPLICANT NAME
First:
Gender:
Middle:
 Male
Last:
 Female
Date of Birth:
(dd/mm/yyyy)
GCAA FILE No (if
available):
Nationality:
GCAA License
Number (if applicable)
Name of
Employer:
UAE National ID
Number (if available)
Tel. No.
(Residential):
Tel. No. (Office):
Mobile Number:
Email:
Facsimile No.
(if any)
UAE Postal Address:
PART 2 – Application Check list
Exam Type
Application for Examination
For GCAA
Use only
Air Law exam
1. Request letter from employer/school
2. One Full color photo with White background, size (35 x 45 mm).
with less than 6 months old. Wearing glasses are not acceptable
as well as head coverings unless for religious reason
3. Passport copy
4. Examination fee -Dhs.200/5. Fast Track Application – additional Dhs.200/- (Within ten
working days)
ATPL/Frozen
ATPL exam
1. Request letter from employer/school
2. One colored photo (White background) size 3.0 x 3.5 cm
3. Letter from approved GCAA School confirming theoretical
knowledge course completion.
4. Copy of passport with visa page or immigration work
authorization.
5. CPL/IR certificate (not required for Frozen ATPL applicant)
6. Copy of UAE Class I medical certificate
7. Examination fee -Dhs.200/-
Form (AC-01)
Revised on 01 Nov 10
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8. Fast Track Application – additional Dhs.200/- (Within ten
working days)
CPL Exam
1. Request letter from employer/school
2.
One colored photo (White background) size 3.0 x 3.5 cm
3.
Letter from approved GCAA School confirming theoretical knowledge
course completion.
4.
PPL Exam
5.
Copy of UAE Class I medical certificate
6.
Examination fee -Dhs.200/-
7.
Fast Track Application – additional Dhs.200/- (Within ten working
days)
1.
Request letter from employer/school
2.
One colored photo (White background) size 3.0 x 3.5 cm
3.
Letter from approved GCAA School confirming theoretical knowledge
course completion.
4.
Instructor rating
Ground
Examination
Copy of passport with visa page or immigration work
authorization.
5.
Copy of UAE Class II medical certificate
6.
Examination fee -Dhs.200/-
7.
Fast Track Application – additional Dhs.200/- (Within ten working
days)
1.
Request letter from employer/school
2.
One colored photo (White background) size 3.0 x 3.5 cm
3.
Letter from approved GCAA School confirming theoretical knowledge
course completion.
4.
Instrument
Examination
Copy of passport with visa page or immigration work
authorization.
Copy of passport with visa page or immigration work
authorization.
5.
Copy of UAE CPL or ATPL License
6.
Copy of UAE Class I medical certificate
7.
Examination fee -Dhs.200/-
8.
Fast Track Application – additional Dhs.200/- (Within ten working
days)
1.
Request letter from employer/school
2.
One colored photo (White background) size 3.0 x 3.5 cm
3.
Letter from approved GCAA School confirming theoretical knowledge
course completion.
4.
5.
Copy of passport with visa page or immigration work
authorization.
Copy of UAE CPL or ATPL License
Form (AC-01)
Revised on 01 Nov 10
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6.
Copy of UAE Class I medical certificate
7.
Examination fee -Dhs.200/-
8.
Fast Track Application – additional Dhs.200/- (Within ten working
days)
PART 3 – LICENSE AND MEDICAL DETAILS:
If you are holder of UAE License, please state the details:
License Type:  ATPL
Category :
MPL
 Aeroplane
 CPL
 PPL
 Helicopter
○Hot Air, Gas Filled, ○Pressurized, ○Combination Gas/Hot Air, ○Balloon Group Rating with an envelop Capacity )
 Balloon (
Group Ratings:
 S/E Land
 M/E Land
Aircraft Type Ratings:
 Instrument
 FI
English Language Proficiency:
 ELP
 S/E Sea Land
 IRI
 CRI
Level:  4
5
 SFI
6
 M/E Sea Land
 STI
 TRI
 MCCI
Re-assess date: ……………………
Do you hold Foreign Pilot license?
 Yes
 No
Authority:……………………… License Number: ……………… Expiry Date: ………………….
Foreign R/T License No………………….
License Type:  ATPL
Category :
MPL
 Aeroplane
ELP level……………………….
 CPL
Re assess date…………………..
 PPL
 Helicopter
○Hot Air, Gas Filled, ○Pressurized, ○Combination Gas/Hot Air, ○Balloon Group Rating with an envelop Capacity )
 Balloon (
Group Ratings:
 S/E Land
 M/E Land
 S/E Sea Land
 M/E Sea Land
Ratings:
 Instrument
 FI
 CRI
 STI
English Language Proficiency:
 ELP
 IRI
Level:  4
 Yes
Number: ……………… Class: ……………………………
Do you hold UAE Medical?
 Yes
Number:……………… Authority: ……………………………
Do you hold Foreign Medical?
5
 SFI
6
 TRI
 MCCI
Re-assess date: ……………………
 No
Expiry Date: ………………….
 No
Class: ………………………
Has any license (UAE or foreign) ever been suspended or revoked?  Yes
If Yes, please submit details:
Expiry Date: ……………..
 No
Has your Medical Certificate ever been refused, downgraded, issued with a waiver, or issued with
a limitation (except for use and carriage of glasses)?
 Yes
 No
If Yes, please submit details:
Form (AC-01)
Revised on 01 Nov 10
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PART 4 –APPLICATION DETAILS FOR EXAM
Applied Category :  Aeroplane
 Helicopter
 Balloon
Exam Types:
 Air Law examination
 PPL examination by applicant attending approved course.
 CPL examination by applicant attending approved course.
 Frozen ATPL FCL Based examination.
 Instrument Rating examination.
 Instructor Rating Ground examination.
 Flight Examiner Examination
 Frozen CPL FCL Based examination.
 VR Communications
 IR Communications
 General Navigation
 Radio Navigation
 Instruments
 Meteorology
 Airframe/Systems
 Performance
 Mass Balance
 Optional Procedures
 Air Law
 Principles of Flight
 Flight Planning
 Human Performance of limitations
Form (AC-01)
Revised on 01 Nov 10
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PART 5- APPLICANT DECLARATION
Photo
With
White
background
Size 3.0 x 3.5
I hereby declare and certify that I have read and understood all the questions and notes set forth in
this application and the answers I have furnished on both pages of this form are true and correct to
the best of my knowledge and belief. I understand that any false or misleading statement may result
in the refusal of this application or the revocation/suspension of the license or rating.
SIGNATURE OF APPLICANT (sign inside the above box)
DATE: ________________
Form (AC-01)
Revised on 01 Nov 10
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Part 6 – For GCAA Use Only- Inspector Remarks
1- Age
 Acceptable  Not acceptable
2- Knowledge
 Acceptable  Not acceptable
3- Skill
 Acceptable  Not acceptable
4- Experience
 Acceptable  Not acceptable
5- Medical
 Acceptable  Not acceptable
 Recommended  Not Recommended  Additional Documents
Inspector Internal comments:
Inspector External comments:
Name of the Inspector ______________________________
Date:______________
RESET
Signature____________________
PRINT
Form (AC-01)
Revised on 01 Nov 10
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