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Employment Opportunities - HELICOPTER SAR CAPTAINS APPLICATION FORM

[All fields must be filled]

Please read the guidelines below prior to entering your application information

GENERAL INFORMATION

Full Name :

Date of Birth :

Nationality :

City / Country of Birth:

Telephone :

E-mail :

Address:

Mobile Phone (If any)

Height: ft/inches

Cms:

Weight: Pounds

Kgs:

Colour of Eyes:

Any scars tattoos or other marks? (Important to note any)

Do you wear glasses or contact lenses?

Yes

If you have answered Yes please reply to additional questions below:

Are they for distance?

Are they bifocal?

Are they contact lenses?

Licenses:

US FAA

UK CAA

CANADA CAA

OTHER?

Country of issue

Type: ATPL(H) or CPL(H) (Note any ATPL License Restrictions)

Class 1 medical Expiry

Helicopter Instrument Rating Expiry Date:

Medical Restrictions If Any

License Restrictions If Any

Additional License

Country of Issue

Type: ATPL(H) or CPL(H) (Note any ATPL License Restrictions)

Class 1 medical Expiry

Helicopter Instrument Rating Expiry Date:

Medical Restrictions If Any

License Restrictions If Any

Additional License

Country of Issue

Type: ATPL(H) or CPL(H) (Note any ATPL License Restrictions)

Class 1 medical Expiry

Helicopter Instrument Rating Expiry Date:

Medical Restrictions If Any

License Restrictions If Any

EXPERIENCE DETAILS
Licensed Since :		Total Flying Hours :
Total Hours Helicopters :		Total Hours Helicopter (PIC) :
Total Hours Offshore Oilfield Production (PIC) :		Total Night Helicopters (PIC) :
Total Night Offshore (PIC) :		Total Underslung Load (PIC) :
Vertical Reference Long Line (PIC) :		Vertical Reference Construction :
Vertical Reference Seismic :		Total Water Bucket :
Total Mountain (above 5,000ft) :		Total Belly Tank :
Spray Hours (Mountain & ULV) :		Instrument Time Helicopters (PIC) :
Total Hours EMS :		Total Bell 206 :
Total Bell 412 (PIC)		Total Bell 212 (PIC)
Total Bell 412 (PIC) Last 12 Months :		Total Bell 212 (PIC) Last 12 Months:
Other Helicopter Twin Time (PIC) :		Total Hours (last 12 months) :
Date of Last Proficiency Check :		Checked in Aircraft Type :
Date Of Last Instrument Check:		Total Instrument Time Last 24 Months:

EMPLOYMENT HISTORY
Current Employer :	Dates :	Aircraft Type :
Previous Employer :	Dates :	Aircraft Type :
Previous Employer :	Dates :	Aircraft Type :

VERBAL REFERENCES
Name :	Company :	Tel No :
Name :	Company :	Tel No :
Name :	Company :	Tel No :

OTHER RELEVANT INFORMATION

GUIDELINES

Applications for Offshore or IFR Operations

Pilots applying for the above categories must possess an UNRESTRICTED ATPL(H) WITH A VALID INSTRUMENT RATING AND A VALID CLASS 1 MEDICAL for that license

Applications for VFR Operations

Pilots applying for the above category must possess a CPL(H) WITH A VALID CLASS 1 or CLASS 2 MEDICAL for that license

Note: For the above categories pilots that possess additional licenses issued by different ICAO contracting states should submit the information for those documents where applicable.