Pilot Training Assessment Form
Mobile number (Include INTL code)
—Please choose an option—A320 / IR Licence Proficiency Check (LPC)B737 / IR Licence Proficiency Check (LPC)A320 Type Rating CourseB737 Type Rating CourseBase TrainingSomething else
—Please choose an option—A320 seriesA330A340A350B737-3-500 EFISB737-6-900NGOther aircraft
Time Frame for Training / LPC
Less than 6 weeks6-12 weeksMore than 12 weeks
Specify all available free dates
—Please choose an option—ATPL(A)Frozen ATPL(A)CPL(A) / IRMPL
Licence Issuing Authority
EASA Licence ?
—Please choose an option—YesNo
Licence Date of Issue
Licence Expiry Date
Class 1 Medical Expiry Date
Current Rating Held on EASA licence
—Please choose an option—A320 seriesA330A340A350A380B737-3-500 EFISB737-6-900NGB737-MAXOther
Date of Last LPC
LPC Expiry Date
Total flight hours
Total PIC hours
Total hours on Type
Total PIC hours on Type
Date Last Flown
—Please choose an option—PICFirst OfficerTrainee
Are you currently flying on a foreign licence validation?
Which foreign licence are you currently flying on?
On your foreign licence, which aircraft rating are you currently flying?
—Please choose an option—A320 seriesA330A340A380B737-3-500 ClassicB737-6-900NGB737-3-900NGB737-MAXOther aircraft
EASA Licence (both parts)
Class 1 Medical certificate (valid)
Last 3 pages of Log Book (1/3)
Last 3 pages of Log Book (2/3)
Last 3 pages of Log Book (3/3)
MCC certificate (if first type rating)
Which Sim centre venue(s) would you prefer to complete your LPC / Type Rating Course ?
Abu Dhabi - EtihadAmsterdamBarcelonaDubai Silicon Oasis - Emirates-CAEDublinIstanbulLondon GatwickMadridManchesterMilanPalma de MallorcaParisOther - Please specify in 'Message'
I certify that the above information is true and accurate.