Pilot Form

Do you have an FAA pilot certificate?*

Yes

No

When was your most recent medical certificate issued?*

Which of the following current medical certificate do you have?*

Class 1

Class 2

Class 3

Basic Med

Do you have any of the following ratings or endorsements?(Select all that apply)*

Instrumental Rating

Multiengine Rating

Seaplane Rating

Tailwheel Airplane Endorsement

Complex Airplane Endorsement

High-Performance Endorsement

Glider Endorsement

High-Altitude Endorsement

Do you have any of the following certifications?(Select all that apply)*

Student Pilot Certificate

Sport Pilot Certificate

Recreational Pilot Certificate

Commercial Pilot Certificate

Flight Instructor Certificate

Airline Transport Pilot Certificate

Remote Pilot Certificate

Private Certificate

How many Take-offs and Landings have you done in the last 6 months?*

Greater than 10

Less than 10

If less than 10, how many have you done? When was the earliest?

Please enter the approximate number of hours you have for Heavy Aircraft:

Please enter the approximate number of hours you have for Airline Transport(ATP):

Please enter the approximate number of hours you have for Regional/Commuter:

Please enter the approximate number of hours you have for Very Light Jet(VLJ):

Please enter the approximate number of hours you have for Rotorcraft - Light:

Please enter the approximate number of hours you have for Rotorcraft - Heavy:

Please enter the approximate number of hours you have for General Aviation:

Please enter the approximate number of hours you have for Powered-Lift:

Please enter the approximate number of hours you have for Weight-Shift-Control Aircraft:

Please enter the approximate number of hours you have for Powered Parachute:

Please enter the approximate number of hours you have for Glider:

Please enter the approximate number of hours you have for Lighter-than-Air:

Please enter the approximate number of hours you have for UAS:

Please enter the approximate number of hours you have for other:

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