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Fadi Alqahtani

The document is a student entry form for Simaero ATO, detailing trainee Fadi Alqahtani's personal and flight information, including his contact details, flight hours, and current position as a first officer. It includes a medical certificate confirming he meets the necessary standards for Class 1 medical certification. The form also requires the submission of various supporting documents and declarations of correctness from the trainee.

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11 views11 pages

Fadi Alqahtani

The document is a student entry form for Simaero ATO, detailing trainee Fadi Alqahtani's personal and flight information, including his contact details, flight hours, and current position as a first officer. It includes a medical certificate confirming he meets the necessary standards for Class 1 medical certification. The form also requires the submission of various supporting documents and declarations of correctness from the trainee.

Uploaded by

ibra.bina95
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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SIMAERO ATO

STUDENT ENTRY FORM

1. TRAINEE IDENTIFICATION (see Note 1)


Last Name: Alqahtani First Name: Fadi
Place of
Date of Birth: 12-09-1993 Egypt
birth:
ID/ Passport
Nationality: Saudi Arabia T816758
number:
Street: Ahmed bin Aseeb Telephone:
City/ Zip
Address: Jeddah Mobile: +966540573888
Code:
Country Saudi Arabia Email: fadi_alqahtani@hotmail.com
Male Captain
Gender: Function:
First Officer ■
Airline
Manasik Aviation Self-sponsor: Yes No ✔
Name:

2. TRAINEE INFORMATION (see Note 1)


ATPL: CPL: ✔ Number: CP-26473
License
EASA: Country of Saudi Arabia
Information:
Other: ✔ Issue:
ME LEVEL:6
Language
Instrument Valid until:
Proficiency: Valid until: No Expiray
Rating:
Type: First Issue: Valid Until:
Type-Rating: A320 No-Expiray
FOR CPL EASA LICENSES
MCC Certificate (Date of Issue):
Theoretical ATPL: Yes No ✔

NOTE I:
Join Copies of:
Passport,
License,
Medical,
Last three (3) pages of Logbook,
Certificate of theoretical ATPL (for CPL licenses),
Certificates of advanced UPRT and MCC for first Type-Rating.

Simaero – Paris Training Center – ATO Student Form – V2 - 2023 Page 1 of 2


SIMAERO ATO
STUDENT ENTRY FORM

5. FLIGHT HOURS AND PREVIOUS EXPERIENCE (see Note 1)


Grand Total: PIC Total:
Total Flying Hours:
1973:22 262:44
Type: Flight Time:

Current Aircraft A320 1702:46


Experience:

3. CURRENT POSITION
First officer

4. TYPE OF COURSE(S) REQUESTED

Trainee: I declare all data above consigned are correct as far I am concerned
Signature: Date:
16/04/2024

Location:

How did you first know about Simaero’s services? Commercial contact

Simaero – Paris Training Center – ATO Student Form – V2 - 2023 Page 2 of 2


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Kingdom of Saudi Arabia
General Authority of Civil Aviation No.:MC-38148 CONDITIONS OF ISSUE
Aviation Medicine Department
MEDICAL CERTIFICATE: Class1 The holder of this certi cate must:
This certi es that (full name and address): 1. Have it in his or her personal possession at all times
FADI ALQAHTANI while exercising priileges of an airman certi cate.
AL NAEEM DISTRICT, JEDDAH (GACAR S 61.9, 64.2, 65.43 and 65.71)
Saudi Arabia
2. Understand that the issuances of a medical certi cate
by an Aviation Medical Examiner may be reversed by
GACA within 60 days.

Dateof Birth Height Weight Hair Eyes Sex


3. Comply with validity standards speci ed for medical
12/09/1993 1.78 79.00 Black Brown Male
certi cates. (GACAR S 61.9, 64.2, 65.43 and 65.71)

Has met medical standards prescribed in part 67, GACA Aviation Regulations, 4. Comply with any statement of functional, operational,
for thiscdassof medical Certi cate. and/or time limitation issued as a condition of
Limitations certi cation. (GACAR § 67.87).
MUST WEAR CORRECTIVE LENSES

(Note: A letter of authorization (or SODA) describing any


such limitation must be kept with this certi cate at all
07/09/2023
times while exercising the privileges of an airman
Date of
Examinations: certi cate).
Examiner
Narne GACA-DAME No. Signature 5. Comply with the standards relating to prohibitions on
Sultan T AI-Otaibi DAME-50 operation during medical de ciency. (GACAR S 61.9, 64.2,
65.43 and 65.71)
AIRMAN'S SIGNATURE

GACA Form 8500-9


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