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1 SKILL TEST IR(A) AEROPLANE SE ME Applition n rport orm A. Uyls nsøgrn/to ill out y th pplint: Dt o Birth: Crtiikt nr./lin no.: (I ny) Ustn Stt/Stt o Lin Issu: Fornvn/First nm(s): Etrnvn/Lst nm: G llr vj:/strt: Postnr. og y/postl o n ity: E-mil: Tl./Tlphon: Dto or unrskrit/dt o signtur: Unrskrit/Signtur: B. Uyls skoln/to ill out y ATO: Nm o ATO: (Us stmp): Spiition o light tim Totl: IFR rout stors Cross-Country:PIC Instrumnt Flight Instrution Instrumnt Groun tim: Night:Quliition optin t? Criting o light tim (tth oumnttion) Dt o signtur o H o Trining Signtur o H o Trining.. C. To ill out y th Exminr: Dt o tst: Lin Enorsmnt: Typ o irrt: Nm o Exminr or stmp: Stmp o Exminr: Authoristion no. o Exminr or stmp: I hry vriy tht th pplint hs pss th rquir trining n tht th pplint ulills th rquirmnt or th tst or hk ing prorm. I lso lr tht I hv rviw n ppli th rlvnt ntionl prours n rquirmnts o th pplint s om-ptnt uthority ontin in th ltst vrsion o th Exminr Dirns Doumnt. Dt o signtur o Exminr Signtur o Exminr Stion 1: Pss Finl rsult: Fil Stion 2: Pss Fil Stion 3: Pss Rsult o th tst Fil Stion 4: Stion 5: Stion 6: Not Applil Pss Fil Tmporry prmit to t s pilot issu (opy nlos): Pss Prtil Pss Fil Ys No Vli until: Trik-, Bygg- og Boligstyrlsn Evr Thomsns Vj Kønhvn S Tl: ino@tst.k Si 1 6

2 For til instrutions s Commision Rgultion 1178/2011 Appnix 7 Us o hklist, irmnship, nti-iing/-iing prours, t., pply in ll stions Nm o Applint: SECTION 1 PRE-FLIGHT OPERATIONS AND DEPARTURE Us o hklist, irmnship, nti-iing/-iing prours, t., pply in ll stions Pss Fil g h I Us o light mnul (or quivlnt) spilly / prormn lultion, mss n ln Us o Air Tri Srvis oumnt; wthr oumnt Prprtion o ATC light pln; IFR light pln/log Intiition o th rquir nvis or prtur, rrivl n pproh prours Pr-light insption Wthr Minim Txiing PBN prtur (i pplil) - Chk tht th orrt prour hs n lo in th nvigtion systm; n - Cross-hk twn th nvigtion systm isply n th prtur hrt Pr-tk o riing; Tk o j(*) Trnsition to instrumnt light k(*) Instrumnt prtur prours, inluing PBN prturs, n ltimtr stting l(*) ATC liison omplin; R/T prours SECTION 2 GENERAL HANDLING Control o th ropln y rrn solly to instrumnts, inluing: lvl light t vrious sps, trim. Climing n sning turns with sustin Rt 1 turn Rovris rom unusul ttitus, inluing sustin 45 nk turns n stp sning turns Rovry rom pproh to stll in lvl light; liming/sning turns n in lning onigurtion Limit pnl, stilis lim or snt t Rt 1 turn onto givn hings, rovry rom unusul ttitus. SECTION 3 EN-ROUTE IFR PROCEDURES* g h Trking, inluing intrption,.g. NDB; VOR; RNAV Us o rio is Lvl light, ontrol o hing, ltitu n irsp, powr stting, trim thniqu Altimtr stting Timing n rvision o ETAs (En-rout hol i rquir) Monitoring o light progrss, light log, ul usg, systms mngmnt I prottion prours, simult i nssry ATC liison omplin, R/T prours Trik-, Bygg- og Boligstyrlsn Evr Thomsns Vj Kønhvn S Tl: ino@tst.k Si 2 6

3 For til instrutions s Commision Rgultion 1178/2011 Appnix 7 Us o hklist, irmnship, nti-iing/-iing prours, t., pply in ll stions Nm o Applint: SECTION 3 ARRIVAL PROCEDURES Stting n hking o nvigtionl is, i pplil Arrivl prours, ltimtr hk Altitu n sp onstrints, i pplil PBN rrivl (i pplil): - Chk tht th orrt prour hs n lo in th nvigtion systm; n - Cross-hk twn th nvigtion systm isply n th rrivl hrt SECTION 4 (*) 3D OPERATIONS(++) Stting n hking o nvigtionl is Chk Vrtil Pth ngl For RNP APCH: - Chk tht th orrt prour hs n lo in th nvigtionsystm; n - Cross-hk twn th nvigtion systm isply n th pproh hrt Approh n lning riing, inluing snt/pproh/lning hks, inluing intiition o ilitis + Holing prour Complin with pulish pproh prour Approh timing Altitu, sp, hing ontrol, (stilis pproh) g+ Go-roun tion h+ Miss pproh prour/lning i ATC liison omplin; R/T prours SECTION 5 (*) 2D OPERATIONS(++) Stting n hking o nvigtionl is For RNP APCH: - Chk tht th orrt prour hs n lo in th nvigtionsystm; n - Cross-hk twn th nvigtion systm isply n th pproh hrt Approh n lning riing, inluing snt/pproh/lning hks, inluing intiition o ilitis + Holing prour Complin with pulish pproh prour Approh timing Altitu/Distn to MAPT, sp, hing ontrol, (stilis pproh), Stop Down Fixs (SDF(s)), i pplil g+ Go-roun tion h+ Miss pproh prour/lning i+ ATC liison omplin, R/T prours Trik-, Bygg- og Boligstyrlsn Evr Thomsns Vj Kønhvn S Tl: ino@tst.k Si 3 6

4 For til instrutions s Commision Rgultion 1178/2011 Appnix 7 Us o hklist, irmnship, nti-iing/-iing prours, t., pply in ll stions Nm o Applint: SECTION 6 - FLIGHT WITH ONE ENGINE INOPERATIVE (multi-ngin roplns only) (*) Simult ngin ilur tr tk-o or on go-roun Approh, go-roun n prourl miss pproh with on ngin inoprtiv Approh n lning with on ngin inoprtiv ATC liison omplin; R/T prours (*) Must prorm y sol rrn to instrumnts * My prorm in n FFS, FTD 2/3 or FNTP II + My prorm in ithr Stion 4 or Stion 5 ++ To stlish or mintin PBN privilgs on pproh in ithr Stion 4 or Stion 5 shll n RNP APCH. Whr n RNP APCH is not prtil, it shll prorm in n ppropritly quipp FSTD Trik-, Bygg- og Boligstyrlsn Evr Thomsns Vj Kønhvn S Tl: ino@tst.k Si 4 6

5 For til instrutions s Commision Rgultion 1178/2011 Appnix 7 Us o hklist, irmnship, nti-iing/-iing prours, t., pply in ll stions Nm o Applint: Dtils o th light Airrt rgistrtion On lok On groun Dprtur rorom O lok Airorn Dstintion rorom Totl lok tim Totl irorn tim No. o lnings: Rmrks/Ovrll ssssmnt/rsons or ilur (i pplil): Nm o instrutor prsnt t th Skill Tst: Signtur o Exminr Signtur o Applint: Trik-, Bygg- og Boligstyrlsn Evr Thomsns Vj Kønhvn S Tl: ino@tst.k Si 5 6

6 For til instrutions s Commision Rgultion 1178/2011 Appnix 7 Us o hklist, irmnship, nti-iing/-iing prours, t., pply in ll stions Nm o Applint: In orn with ARA.GEN.315(), () () Unrtgn krætr hrm, t jg v nsøgningstispunktt Not: 1. ikk vr i sils t prsonligt rtiikt, rting, tillls llr ttsttion m smm nvnlssområ og i smm ktgori ustt i n nn mlmsstt; 2. ikk hr nsøgt om t prsonligt rtiikt, rting, tillls llr ttsttion m smm nvnlssområ og i smm ktgori i n nn mlmsstt; og 3. lrig hr ht t prsonligt rtiikt, rting, tillls llr ttst m smm nvnlssområ og i smm ktgori ustt i n nn mlmsstt, som r tilgklt llr suspnrt i nn mlmsstt. Ukorrkt oplysningr vrørn ovnstån, kn vær iskvliirn or ustls rtiikt, rting, tillls m.v. Unrsign hry onirm tht I t th tim o pplition Not: 1. ws not holing ny prsonnl lin, rtiit, rting, uthoristion or ttsttion with th sm sop n in th sm tgory issu in nothr Mmr Stt; 2. hs not ppli or ny prsonnl lin, rtiit, rting, uthoristion or ttsttion with th sm sop n in th sm tgory in nothr Mmr Stt; n 3. hs nvr hl ny prsonnl lin, rtiit, rting, uthoristion or ttsttion with th sm sop n in th sm tgory issu in nothr Mmr Stt whih ws rvok or suspn in ny othr Mmr Stt. 4. Inorrt inormtion rgring th ov n isquliying or otining rtiit, rting, uthoriztion, t. Dto/Dt: Unrskrit/Signtur: Trik-, Bygg- og Boligstyrlsn Evr Thomsns Vj Kønhvn S Tl: ino@tst.k Si 6 6

EIR(A) AEROPLANE SKILLTEST PROFICIENCY CHECK SE ME Application and report form A. Udfyldes af ansøgeren/to be filled out by the applicant:

EIR(A) AEROPLANE SKILLTEST PROFICIENCY CHECK SE ME Applition n rport form A. Ufyls f nsøgrn/to fill out y th pplint: CPR-nr./Dt of Birth: Crtifikt nr./lin no.: (If ny) Ustn Stt/Stt of Lin Issu: Fornvn/First