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GENERAL POLICY

This document is mandatory by regulations.

This document signed by the trainee and Airline training Responsible must be addressed to ATCT 6 week’s prior the start of training together with a copy of the trainee’s pilot licence and copy of last 3 pages of logbook.

Trainee Information

Family name *

First name *

Date of birth *

Place of birth *

Sex *

Male

Female

Nationality *

Passeport NB *

Place of issue *

Validity *

English level *

Trainee licence information

Type of licence *

ATP

CPL

Other *

Licence based in *

JAA

FAA

National Regulations

Licence number *

State of issue *

Valid until *

Multi Engine instrument rating *

Includedinlicence or

Valid until

Valid until *

Ratings on licence

Air craft type *

Valid until *

Hrs flows on type *

Date last flight *

Instructor rating *

YES

Valid until ( if YES )

On *

A / C Type *

Total time as pilot *

Including hours as Pic *

ANDF / O *

Hours flown on jet aircraft *

In case of first issue of a multi pilot type rating

MMC ( multi crew certificate ) *

Date of delivery *

By *

Hours as pilot flying on multi engine aircraft *

Date last flight *

Multi engine instrument rating

Valid until *

Or expired since *

i undersigned certify that all the above statements are true and will comply with the general policy stated on this document

DECLARATION BY TRAINNE

Name *

Date *

* Required fields

ATCT, Les côtes de Carthage, BP 77, Zone touristique 1057 Gammarth. Téléphone : +216 71.274.401 Fax : +216 71.274.510 EMAIL : atct@atct.com.tn
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