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Pre-Course Assessment Form v3 Fillable Vect

This document is a pre-course assessment form for an ATR 72 recurrent training course. It collects information about the client such as personal details, license and medical details, and previous flight experience.

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Oyuka Shinebold
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© © All Rights Reserved
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254 views1 page

Pre-Course Assessment Form v3 Fillable Vect

This document is a pre-course assessment form for an ATR 72 recurrent training course. It collects information about the client such as personal details, license and medical details, and previous flight experience.

Uploaded by

Oyuka Shinebold
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PRE-COURSE ASSESSMENT FORM

COURSE INFORMATION:
Start Date: 18 FEB 2017 Course Requested: ATR 72 RECURRENT TRAINING
Aircraft Type: ATR 42/72 Preferred CAE Training Location: Amsterdam
Self-Sponsored: YES NO Airline / Employer: HUNNU AIR

CLIENT INFORMATION:

Captain F/O Other :______ Male Female Nationality: MONGOLIA

First Name(s): GANPUREV Date of Birth: 26 NOV 1988


Surname: BOLDBAATAR ID / Passport: E 1442955
E-Mail: ganpurev@hunnuair.com Telephone No: (+976) 99974753
GERGE TOWER, CHINGGIS AVENUE 17 KHOROO 1, SUKHBAATAR DIS
Address:

LICENSE INFORMATION AND PREREQUISITES:


EASA State of License Expiry
Authority: MONGOLIA 27 SEP 2017
NON-EASA License Issue: Date:

CPL + ATPL Theory


License Number: ME/IR Expiry Date: 27 SEP 2017
ATPL

MCC Certificate If No: a minimum of 500 hours as a pilot in multi crew operations on aircraft or
(only required for Yes No
first type rating): helicopter is required.

ICAO English Level: 4 Medical Class 1 Expiry Date: 20 JAN 2017

FLYING HOURS AND TYPES ON LICENSE:

Total Flying Hours: Hours on Hours on Type


2,991 Current Type:
387 Requiring Renewal:

Flight Time Total Flying


527 2,726 Total Hours PIC: 182
Last 12 Months: Hours MPA:
A/C TYPE: Last Flight: Expiry of Last LPC/OPC:
ATR-72 4 FEB 2017 23 FEB 2017

Other qualifications currently held by client: SFI or TRI SFE or TRE


I understand that on the first day of training I will be required to present a valid license and medical class 1.
If this is my FIRST multi-engine multi-pilot type rating I will also be required to present a valid ME IR, MCC Course Completion Certificate or
equivalent and ATPL theory results.

Under the terms of the data protection act 1998, I understand that the above information will be kept strictly confidential in secure paper or
digital files for 3 years. It will be used by CAE personnel and may be disclosed to certifying authorities and can be used for the detection of
fraud.

Signature: ________________________________________________ Date: ______________________________


Received by (Full name in block capitals): Checked by (Full name in block capitals):
Reserved
for CAE

CAE CAE Pre-Course Assessment / Client Form


Training Process CAE DK/ATO/005
Electronic document, uncontrolled when printed Issue date: 10 Dec 2013

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