Pilot Application Form

Name
(as appears in passport):
 1 PERSONAL INFORMATION
Full Name: Date of Birth: Gender: Male
Marital No. of
Nationality:
Status: Children:
Permanent
Address: Age:

Present
Address
Date of
Passport No. Date of Issue
Expiry:
Place of
Gateway City:
Issue
Note: Please include country & city code as well
Permanent Work
Tel: Tel:
Present
Mobile:
Tel:

Fax: E-Mail:

Note: Please write the highest educational attainment

Education Graduation
Certificate: Date:

2-1 LICENSES
Licenses Issuing authority Rating Number Expiry Date

2-2 MEDICAL CERTIFICATE

Medical Cert Class Issuing authority Issue date Expiry Date

3 AIRCRAFT TYPE RATING

Aircraft Total Time Pilot in command Co-Pilot Rating Expiry Date

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 4 FLIGHT TIME

Total Time Time on A320 Type = PIC = / SIC

Jet PIC/SIC Time PIC = / SIC = Last Flight on A320

5 Training Courses
Course Date

6 EMPLOYMENT INTEREST
A What sort of notice period in term of weeks you are required to your present employer?

B Estimated start Date with flynas?

Note: Please/ list all employment, starting with most recent position

# Name of Company Start date End Date Job Title Salary

Note: Please justify any reasons for gaps in your employment history if any

Justification:

C Have you ever had or being involved in any aircraft accident or incidents up to this date?

___ if you answer with "YES", please write a separate letter for further explanation.

D Has your pilot or medical certificate ever been revoked or suspended by any aviation authority?

____ if you answer with "YES", please write a separate letter for further explanation.

3
F Were you previously employed by flynas, if so when?

M Were you previously interviewed by flynas, if so when and where

8-1 REFRENCES - At least two references (DFO/Chief Pilot/ Head of Training) with official
company email addresses from previous or current employers.
Co. Title Tel Mobile E-Mail
1 Name:

2 Name:

3 Name:

8-2 Have you had any criminal records/history ?

____ if you answer with "YES", please write a separate letter for further explanation.

ALL BLANKS HAVE TO BE FILLED OUT BEFORE SUBBMISSION OTHERWISE IT

WILL BE SUFFICIENT CAUSE FOR CANCELLATION

ACKNOWLEDGEMENTS

1. I certify that all statements I have made in this application are true and understand that any
misrepresentation or omission of facts requested may be sufficient cause for cancellation of my
application or immediate dismissal from the Company if I have been employed. In the event I am
employed, I agree to conform to the rules and policies of the Company. I understand that these rules and
policies may be changed, interpreted, modified, withdrawn or added to at the Company’s option at any
time without notice.

2. I understand that employment is contingent upon meeting the physical requirements of the job and
passing, to the Company’s satisfaction, a drug screen. Depending upon the nature of the job for which I
am applying, I understand that the satisfactory completion of a post-hire physical examination may also
be required.

3. I acknowledge the Company’s notification to me that a background investigation or an investigative

consumer report, on me may be made. I understand that successful completion to the Company’s
satisfaction of such investigation (s) is required for employment or continued employment. I hereby
authorize the company to conduct or have conducted the investigation (s) described above and to prepare
or cause to be prepared a report based on such information. I further understand that, upon my written
request, a complete disclosure of the nature and scope of the investigation (s) conducted will be provided
to me.

4. I understand that my disclosure of prior convictions for criminal or traffic offenses will not necessarily
prevent my employment with the Company; however, the omission of this requested information will be
sufficient cause for cancellation of my application or my immediate dismissal from the Company.

I HAVE READ AND UNDERSTAND THE ABOVE ACKNOWLEDGEMENTS.

Signature Required: Date:

Forwarding this form electronically, will be considered as
an ACKNOWLEDGEMENT