Form12: FAA/ICAO CPL To EASA Conversion

FAA/ICAO CPL To EASA Conversion

Fill out the form carefully for registration
Applicant Name*

First NameMiddle NameLast Name
Date of Birth*

DayMonthYear
Address*

Street Address Line1

Street Address Line 2

CityCountry

Post Code
Phone Number*

Country CodePhone Number
Email*
Nationality*
Passport Number*
Passport Expiry*

DayMonthYear
Emergency Contact*
Emergency Contact Number*

Country CodePhone Number
Is English your first language?*
If no, what IELTS English level?
Have you ever been convicted of a criminal offence? *
Do you hold a current ICAO complaint Private Pilot Licence?*
What is your total number of flying hours in fixed wing aircraft?*
What is your total number of PIC hours in fixed wing aircraft?*
Do you hold an EASA class 1 or class 2 medical?*
Candidate Declaration*

I hereby certify that all information I have given in this application, along with any supporting documentation, is correct and that no relevant information has been withheld.
Signed Date*

DayMonthYear
‍We need you to provide the following along with this Application :
1.Photocopy or scanned image of your Passport or Drivers Licence*

Cancelof
2.Photocopy or scanned image of your ICAO CPL*

Cancelof
3.Photocopy or scanned image of your last three pages of your pilot logbook*

Cancelof
Should be Empty: