1 of 3 CAAM Borang 6-IAR-Pin 1/17 A – APPLICANT’S DETAILS To be completed by the applicant (tick appropriate box) Application type: Initial Renewal Organisation/Employer: Applicant’s name: (Capital Letters) Date of birth: (dd/mm/yy) Nationality: MyKad/Passport: Medical Certificate Class: Date of last Medical: (dd/mm/yy) Date of Expiry: (dd/mm/yy) Permanent Address: Telephone Number: Mobile telephone: E-mail: B – FLIGHT CREW LICENSE DETAILS To be completed by the applicant (tick appropriate box) Flying School Graduate: Flying Training School: Graduation Date: (dd/mm/yy) Aircraft category: Aeroplane Helicopter Balloon ELPT Level: 4 5 6 Type of licence: ATPL CPL PPL BPL Licence No: Aircraft type rating SE ME IR FSTD: Last PPC issue date: (dd/mm/yy) Type rating: AE Name/ AE No: Applied License Endorsement: Logbook Hours Total PIC SIC Solo Solo x- country Total x- country Instrument Simulated Instrument PIC Night Total Night Flight Instruction* Aeroplane Helicopter Balloon C – PREFERRED ATO AND TIMING DETAILS To be completed by the applicant Preferred ATO: Aircraft Class or Type: Date of Training: INSTRUCTORS APPLICATION FORM Initial / Renewal Assistant Flight Instructor Flight Instructor Class Rating Instructor Instrument Rating Instructor Type Rating Instructor Flight Simulator Instructor MCC Instructor Synthetic Training Instructor
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CAAM Borang 6-IAR-Pin 1/17
A – APPLICANT’S DETAILS To be completed by the applicant (tick appropriate box)
Application type: Initial Renewal
Organisation/Employer:
Applicant’s name: (Capital Letters)
Date of birth: (dd/mm/yy)
Nationality: MyKad/Passport:
Medical Certificate Class: Date of last Medical: (dd/mm/yy)
Date of Expiry: (dd/mm/yy)
Permanent Address:
Telephone Number: Mobile telephone:
E-mail:
B – FLIGHT CREW LICENSE DETAILS To be completed by the applicant (tick appropriate box)
Flying School Graduate: Flying Training School: Graduation Date: (dd/mm/yy)
C – PREFERRED ATO AND TIMING DETAILS To be completed by the applicant
Preferred ATO:
Aircraft Class or Type:
Date of Training:
INSTRUCTORS
APPLICATION FORM
Initial / Renewal
Assistant Flight Instructor
Flight Instructor
Class Rating Instructor
Instrument Rating Instructor
Type Rating Instructor
Flight Simulator Instructor
MCC Instructor
Synthetic Training Instructor
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D – DECLARATION OF APPLICANT
I hereby confirm my compliance with the FOD – FCL and declare that the information provided on this form is correct. I enclose payment for the charges payable on application in accordance with the Civil Aviation (Fees and Charges) Regulations 2016. I agree to pay any additional charges which may become payable in respect of this application under Civil Aviation (Fees and Charges) Regulations 2016. Please note that failure to submit all of the required documentation and information will lead to a delay in processing your application.
Applicant’s Signature:
Date: (dd/mm/yy)
E – INSTRUCTOR APPLICATION CHECKLIST To be completed by the FOI
Ser. Item For CAAM use only
1. Instructor prerequisite, minimum hours and specific requirements are as stipulated by FOD – FCL.
2. Hold a license & rating at least equal to the license & rating for which he will be issued an instructor certificate.
3. Hold appropriate instructor rating for which he will be issued an AFI/FI/CRI/IRI/TRI/FSI/MCCI/STI certificate. Conduct type rating course or attend the instructor refresher course. Copy of the instructor certificate is required.
4. Qualified to act as PIC of the aircraft during flight check, if manipulating the flight controls.
5. Passed a minimum CPL theoretical knowledge examination. Copy of the theoretical examination certificate is required (for initial).
6. Original and copy of the Logbook (relevant pages).
7. Original and copy of the license (all pages).
8. Copy of two consecutive previous PPC/OPC Check report (for the applicant).
9. Application fees for initial or renewal – Instructor (RM300).
10. Two colour photo passport size (name of applicant at the back of the photo – for initial).
F – FOR CAAM OFFICIAL USE ONLY To be filled by the FOI
I certify that the applicant meet / does not meet* all the requirement as stated in the application form for the applicant of AFI / FI / CRI / IRI / TRI/ FSI / MMCI / STI * (*strike as necessary) Tick appropriate box Initial Renewal
Name of FOI: (Capital Letters)
Signature & Stamp:
Date: (dd/mm/yy)
REMARKS BY DIRECTOR OF FLIGHT OPERATIONS (if any)
Name of DFO: (Capital Letters)
Signature & Stamp:
Date: (dd/mm/yy)
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FOR CAAM OFFICIAL USE ONLY
Information Checked _________________________________________________________ Application Fee:
The application is to be filled out by typing or writing clearly in capital letters:
(A), (B), (C) & (D) The applicant shall complete this section. (E) The instructor application checklist as reference and shall be ticked by the FOI. (F) The FOI shall certify whether the applicant meet or does not meet the requirement for instructor application and remarks by the DFO (if any).
