APS MCC Intake form – Orbit-Groundschool

Name *

Voornaam

Tussenvoegsel

Achternaam

Nationality *

Country of residence *

Gender *

Date of birth *

Photograph *

Drag & Drop Files, Choose Files to Upload

Attach a photograph of yourself (Max 1 file | JPG, JPEG, PNG, PDF | Max 10 MB)

Address information *

Adres regel 1

Stad

Staat / Provincie / Regio

Postcode

Land

Contact information *

Please provide a phone number where we can reach you easily.

Email *

Preferred APS MCC Course start date *

Current or most recent flight training *

Flight school or Airline *

Country of Issue *

CPL(A) completion date *

IR(A) / ME-IR completion date *

ATPL(A) theory successfully completed *

Yes
No

ATPL(A) theory completion date *

Which ATPL training provider *

Number of resits *

Overall average (%) *

Highest subject *

Lowest subject (kopie) *

Licence held *

Ratings held *

Licence issued by *

Licence number *

Medical certificate *

Class 1
Class 2
Other

Medical valid until *

Total flight experience *

Pilot in command flight experience *

Co-pilot flight experience *

Dual flight experience *

Single engine piston (SEP) flight experience *

Multi engine piston (MEP) flight experience *

Total multi engine flight experience *

Instrument flight time (actual) *

Instrument flight time (simulated) *

Simulator / FNPT / FSTD experience *

Night flight experience *

Cross-country flight experience *

Total IFR *

Date logbook totals established *

Date of last flight as pilot flying *

Aircraft type *

Flight duration of last flight

Geselecteerde waarde: 0

Date of last MEP flight *

Aircraft type *

Flight duration of last MEP flight

Geselecteerde waarde: 0

Most recent IF/IR experience

IF/IR hours in last 3 months *

IF/IR hours in last 6 months *

IF/IR hours in last 12 months *

Intended APS MCC Course start date

Date of last verifiable IF/IR flight or simulator session

Time between last IF/IR experience and APS MCC start:

Less than 3 months
More than 3 months

Insufficient information / additional information required

Preliminary review

Sufficient recent IF/IR experience
Limited recent IR/IR experience
No verifiable IF/IR experience within the last 3 months
Additional preparation recommended
Discuss with head of training / chief flight instructor

Orbit Groundschool remarks *

Date of CPL skill test

Result of CPL skill test

Date of IR / ME-IR skill test

Result of IR / ME-IR skill test

Date of latest proficiency check, assessment or simulator session *

Type of check / assesment *

Examiner / instructor remarks *

Current instrument flying proficiency *

Aditional comments *

Knowledge of IFR procedures, SOP's, briefings and multi-crew concepts *

Aditional comments *

Additional training completed in preparation for MCC, APS MCC or Type Rating? *

Yes
No

If yes, please specify

Scans of documents to be submitted

Drag & Drop Files, Choose Files to Upload Je kunt tot 15 bestanden uploaden.

* Do not forget to include with this application: Copies of licenses (if applicable). EASA medical. Copy of least 3 last pages logbook (if applicable). Evidence of latest IF/IR flight of simulator session, Skill test results, additional reports or instructor comments (Max 15 files | JPEG, JPG, PNG, PDF | Max 10 MB).

Candidate declaration *

I declare that the information provided is complete and accurate. I understand that Orbit Groundschool B.V. will use this information to review my recent flight experience, total flight experience, instrument proficiency and training background in preparation for the APS MCC Course. Orbit Groundschool may request additional information, documentation or preparatory training if considered necessary.

By accepting this document I certify that the answers given by me in this application are correct to the best of my knowledge as well I have a full understanding of the foreseen process, application and course, license or conversion procedure. I understand that any falsification of this application, whether willing or accidentally, is ground for refusal for admission to a course of training at Orbit Groundschool*. I understand if I’m enrolled in a training course, the fee for the ATP-digital software will not be returned to me, unless the course material is returned undamaged and unused without installments of the software and within 7 business days upon receiving as well I have read and understood the general Terms and Conditions.

Do you accept our Terms and Conditions? *

Yes, I understand and agree to the terms and conditions that are stated below.

By accepting this document I certify that the answers given by me in this application are correct to the best of my knowledge as well I have a full understanding of the foreseen process, application and course, license or conversion procedure. I understand that any falsification of this application, whether willing or accidentally, is ground for refusal for admission to a course of training at Orbit Groundschool*. I understand if I’m enrolled in a training course, the fee for the ATP-digital software will not be returned to me, unless the course material is returned undamaged and unused without installments of the software and within 7 business days upon receiving as well I have read and understood the general Terms and Conditions.

Reviewed by

Function

Head of training
Chief flight instructor
MCC / APS MCC instructor
Training administration

Date

Conclusion

Candidate may commence APS MCC
Candidate may commence following additional preperation
Additional IF / IR of siumulator training recommended
Do not admit at this stage
Decision postponed pending additional documentation

Recommended action if last IF / IR experience exceeds three months

Comments / motivation

Final approval

Yes
No
Conditional

Orbit Groundschool declaration

I declare that the information provided is complete and accurate.

By accepting this document I certify that the answers given by me in this application are correct to the best of my knowledge as well I have a full understanding of the foreseen process, application and course, license or conversion procedure.

Intake formulier APS MCC

Orbit Groundschool

Opleidingen

Informatie

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