Marine pilot application form
PERSONAL DETAILS
·
Surname
·
Given Names
·
Preferred Name
·
ARN
·
Date of Birth
CONTACT DETAILS
- Address
- Suburb
- State
- Country
- Postcode
- Home
Phone
- Mobile
- Work
Phone
- E-mail
FLYING EXPERIENCE
- Licence
Type
- Full ATPL Theory
Pass
- Total
Flying Hours
- Multi
PIC hrs
- Night
Hours
- IMC
Hours
- Turbine
Hours
- BE58
Hours
- C208B
Hours
- Metro
3/23 PIC Hours
- Metro
3/23 FO Hours
- Total
hrs last 12 months
- Total
hrs last 6 months
- Total
hrs last 30 days
Endorsements
FLYING QUALIFICATIONS
- GPS
course completed?
- CRM
course completed?
- CFIT
course?
- Dangerous
Goods exp date
- Instructor
Rating exp date
- First
Aid Certificate exp date
- Command
Multi Instrument Rating Expires
Check and Training
Approvals Type/Hrs
- IFR
Testing /
- Endorsement
Training /
- Check
Captain /
- Training
Captain /
- Supervisory
Captain /
- Co-Pilot
Multi Instrument Rating Expires / /
CAREER GOALS
………………………………………………………………………..
………………………………………………………………………..
………………………………………………………………………..
EMPLOYMENT HISTORY
Last or
Current Employer
- Period of Employment From /
/ To /
/
- Company
- Supervisor’s Name
- Telephone
- Reason for Leaving
Previous Employer 1
- Period of Employment From /
/ To /
/
- Company
- Supervisor’s Name
- Telephone
- Reason for Leaving
Previous Employer 2
- Period of Employment From /
/ To /
/
- Company
- Supervisor’s Name
- Telephone
- Reason for Leaving
WORK REFERENCES
Please
list three (3) persons whom Toll Aviation may contact for reference regarding
your previous / current employment, at least one (1) of whom must be qualified
to comment on your flying skills.
Reference 1
………………………………………………………………………..
………………………………………………………………………..
Reference 2
………………………………………………………………………..
………………………………………………………………………..
DECLARATION
I declare that all the information given by me in this
application is accurate and to the best of my knowledge, true and correct. I
understand that if any information given by me is found to be false before
employment, Toll Aviation may refuse to employ me, and employment may terminate
immediately and without notice if I am already employed.
Applicant’s Signature:_____________________ Date:
/ /
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