Flight training request - application form

Personal information

Title (Mr, Mrs, Ms...)	First name	Middle name

	Surname

Address (street, number)	County/Region

City	Postcode/ZIP

Country

E-mail	Phone

Date of birth (dd.mm.yy)	Place of birth

Nationality

Passport number	Passport date of issuance (dd.mm.yy)

Place of issuance	Passport expiry date (dd.mm.yy)

Do you need VISA to the Czech Republic?

YES

Pilot licence

Do you hold valid pilot licence?

YES

If yes, state the type of licence and qualifications
	JAA	FAA	other

Country of issuance	Date of issuance	Licence number

Do you hold pilot insurance?	Yes	No

Medical certificate

Do you hold valid JAA medical certificate?		YES	NO
Class of certificate	1^st class	2^st class	other
If yes, please state country of issuance		If yes, please give date of issuance

Required training

Please indicate which courses you are applying for by ticking the relevant boxes.

Theory	PPL	IR	CPL	ATPL	Aviation English
Training	PPL	IR	CPL	MEP	MCC	FI
Programme	0-ATPL (includes all courses from zero to ATPL frozen licence)

Please give us the approximate date you would like to start with the course (dd.mm.yy)

Flight hours (fixed wing)

Total hours		Type of aircraft
PIC hours
IR flight hours		Date of last flight (dd.mm.yy)

Other

Do you need to arrange accommodation?		Yes	No
If yes, please choose the level	Cheap	Standard	Luxury
Do you want to pick up at the airport?		Yes	No

Note

Documents

Before submission of this application, please make sure you have enclosed the correct supporting documentation as listed below.

Photocopy of passport
Photocopy of your pilot licence (if you hold any)
Photocopy of JAA medical certificate (if you hold any)
Photocopy of Radiotelephony licence (if you hold any)
Last two pages of your logbook (if you hold any)
Photocopy of high school certificate or University diploma (just CPL/ATPL applicants)

Remember than in time of issuance of your licence at Czech Aviation Authority (CAA) you will need to bring forward your criminal record from your country. This document may not be older than 3 months!