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DPE/INSTRUCTOR Booking Form
Personal Information
First Name and ALL middle names as indicated on your passport:*

All names listed in passport
Last Name:*

E-Mail:*

Address Line 1:*

Address Line 2:

City:*

Post Code:*

Country*

Nationality*

Gender:

Date of Birth:*

Phone:*

Height (Inches Only):*

Weight (Pounds Only):*

Service Required*

1st TEST Required (if applicable)

2nd TEST Required (if applicable)

3rd TEST Required (if applicable)

Requested date of Service

A/C Reg, Make & Model (If Required)

Requested Location of Service

Do you hold an FAA Pilot Certificate? If so, please indicate certificate number and grade.*

Do you hold an FAA Medical Certificate?*

If so, what Class?
Have you ever had an FAA Certificate Revoked?*

Non-FAA ICAO Licenses & Ratings held*

Country of Issue
FAA Endorsing Instructor`s FULL Name and Certificate Number - MANDATORY FOR FLIGHT TESTS*

If applicable
Remarks

By checking the box below, you are confirming that you (and your FAA CFI if flight test) have read, understand & agree with
SCH AIRCRAFT CONSULTANCY LTD`s Terms & Conditions of Service
AND THAT YOU (AND YOUR CFI IF FLIGHT TEST) HAVE REVIEWED AND UNDERSTAND THE INFO ON THE PROBLEMS & USEFUL INFO PAGE*
and that Bookings cannot be confirmed until full payment of fees has been received.
I Agree*

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