Pilot Exam Form

CA-9 (PILOT): Rev July, ‘07

APPLICATION FORM FOR PILOTS EXAMINATION (GEN & TECH) 1. COMPUTER NO.

2. SESSION

3. FEES: Amount Rs : …………. Demand Draft No.…………….. Dated………….. Issue branch………… ………………………….

PM M Y Y Y

Y

Demand Draft should be Payable to: PAO, DGCA, MCA, New Delhi. Note : Enclose duly filled in Annexure-1 if appearing for first time or if change of category

4. NAME:……………………………………………………………………… 5. EXAM. CENTRE:

7. Category of License and papers, the applicant desires to appear: (a) CATEGORY of License

PPL / CPL / CHPL / ATPL / CPLCG/ / ATPLCG …etc.) Fill only one Category in this box

i) General Papers: (fill the appropriate boxes given below with YES/NO): Navigation Meteorology Regulation Radio aids & Inst

Composite

ii) Technical Papers : (fill the appropriate boxes given below with YES/NO): Tech. Gen(P-1) Specific ( P-2)# Performance( P-3)# Name of Aircraft with model

#Submit course completion certificate, if appearing in Paper-2 (Specific) / Paper 3 (Performance) on any type of aircraft 8. Details of valid Indian Licence held

)

Category of Licence………… License Number………… Validity…………… 9. Total Hours Flown:………….Hrs.………Minutes

(Enclose attested copy of Licence )

(Enclose attested copy of certified Log Book)

10. Educational Qualification ……………………. (Enclose attested certificate of 10 + 2 with Physics & Maths) 11. Name and address of DGCA approved Flying Training institute: …………………………………………………………………… 12. Name and address of DGCA approved Ground Training Institute:………………………………………………………………… 13. For CONVERSION to Indian license, furnish details of Foreign Pilots license held: Country of issue ………………… Category………….. License No ….……… Validity ………………… (Enclose attested copy of the license) 14. Details of last two examinations attempted by the candidate: Session Roll No. Subjects Cat. Nav / Met. appeared Comp

Reg,

Radio Aids & Inst.

Tech. P1

Tech. P2

Tech. P3

Marks obtained Marks obtained I hereby declare that the above particulars are true in every respect and that nothing has been concealed or withheld by me. If any of my statements are found false at any time, my candidature shall be rejected. I have read and understood the requirements for issue of Pilots License, and the instructions for appearing in examinations as detailed in the CAR.

Date: ………..........

Signature of applicant ……………………………

Note: - Applications incomplete in any respect or without required enclosures / documents or requisite fees shall be rejected.

CA-9 (PILOT): Rev Jul 07

ANNEXURE - 1 NOTE :

THIS ANNEXURE IS ALSO REQUIRED TO BE FILLED UP ALONG WITH CA-9 (PILOT) FORM WHENEVER APPEARING FIRST TIME IN PPL OR CPL OR CHPL OR ATPL EXAMINATION OR CHANGE IN CATEGORY

1.

Computer Number:

2.

Name of applicant: ……………………………………………………………..

3.

Date of Birth: …………………..

4.

Educational Qualification ………………………….

NOTE:

Enclose the attested copy of Marks-sheet of 10+2 with Physics & Mathematics,

5.

Category of License, applicant desires to appear: ……………

6.

Details of Pilots’ Licence already held by the applicant: (i) Category of Licence: ……………..

(Enclose the attested copy of the License).

(ii) Licence No.: ……………… (iii) Validity: …………………….

(iv) Is the CPL endorsed for Multi-engine Rating, YES / NO:…………….. (v) If yes, name of the aircraft…………… 7.

Name and address of the DGCA Approved Ground Training Institute:………………………………………………… …………………………………………………………………………………………………………………………………

8.

Details of Flying: (a) Total Flying Hours :

Hrs ………………Mts ………………..

(b) Flying Hours as PIC: Hrs ……………. Mts ………………….. Note: Enclose attested copy of the last page of the Pilot Log book containing the summary of flying hours duly certified by the CFI /GM (Ops.) / Commanding Officer , This page should bear the name and date of birth of the pilot or pilot trainee. ______________________ Signature of applicant

Date : CERTIFICATE

Certified that Mr./ Ms ……………………………………………attended classes for the ground subjects at the above mentioned Institutes and further certified that he / she has flying experience, as mentioned above.

Place:……….. Date:…………

SEAL

Signature of CFI / GM (Ops.)/ Commanding Officer