QuickTime™ en een -decompressor zijn vereist om deze afbeelding weer te geven.
FLIGHT DECK APPLICATION FORM Thank you for your interest in a position to join the flight deck of Corendon Dutch Airlines. Corendon Dutch Airlines maintains a policy of non-disclosure of any information provided to us. We will not contact any of the references or contacts at your current employer before your explicit approval. False details or intentional suppressions of relevant information and materials will render you liable to disqualification, or, if appointed, result in automatic termination and / or appropriate legal proceedings. 1. 2. 3. 4. 5. 6. 7.
8. 9.
Do not leave any items blank. If any items are not applicable to you, please indicate “N.A.” Hours should be rounded to the nearest hour Command hours should only include time when operating as the nominated Pilot-in-Command (PIC) Cruise Captain hours (P1U/S) should be logged along with First Officer time Second Officer hours should only be logged under Second Officer. In addition Flight Engineer hours should be logged as Second Officer time Please do not include simulator hours unless specifically asked for. After completing this application form, please save it with the date (format YYYYMMDD) and your last name followed by your first name. Example format: “20110101VliegernierPiet.pdf” Write an e-mail to Corendon Dutch Airlines at:
[email protected] Please attach the saved application form (as first attached document) and along with the following scanned documents: a. Your passport, showing all relevant details b. Flying licence(s) c. Medical certificate(s) class 1 d. The detailed results of your last 4 prof checks (OPC/LPC) e. Logbook pages including the last 50 flights f. Your Curriculum Vitae
I understand all rules and information mentioned in this leaflet, Name and initials Place and Date (day-month-year) Signature
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Personal details: Name First names Date of Birth (DD-MM-YY) Nationality Marital status Email address Address City Country Telephone number
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Position applied for O Commander O First Officer, High potential (min. 4000 hrs total time and 2500 hours B737NG) O First Officer (Type rated B737 with min. 800 hours and recent on type; 30T MPA (JAR-FCL 1.220) Boeing 737- 600 t/m 900 Boeing 737- 300 t/m 500
First Officer
Name:
Signature:
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QuickTime™ en een -decompressor zijn vereist om deze afbeelding weer te geven.
Flying experience: FromTo
Airline
Time
Type of Aircraft
Commander First Officer
Pilot-in-Command
Second Officer
First Officer
Multi Engine Simulator level C/D
Total time Single- and Multi Engine JAR/FAR etc.
When & Where did you receive your professional flying training?
Date of Last Medical class 1: Date of Expiry: Restrictions: Issuing Authority: Name:
Signature:
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Date of last flight
Second Officer
QuickTime™ en een -decompressor zijn vereist om deze afbeelding weer te geven.
Education & Qualifications Type of education
Qualifications achieved / Degree received
From To
Please indicate with: Basic / Intermediate / Fluent / Mother tongue Language Spoken Written Dutch English
Motivation Please tell us why you would like to join Corendon Dutch Airlines:
Name:
Signature: 4
QuickTime™ en een -decompressor zijn vereist om deze afbeelding weer te geven.
Miscellaneous Have you ever been involved in any aircraft accidents or incidents? If yes, please specify on separate sheet.
Yes
No
Has your flying licence ever been revoked or suspended? If yes, please specify details on separate sheet.
Yes
No
Have you ever been convicted of a criminal offence? If yes, please provide details on separate sheet.
Yes
No
Has your driving licence ever been revoked or suspended? If yes, please specify on separate sheet.
Yes
No
Have you ever been grounded for medical reasons or has the renewal of your licence ever been deferred on medical grounds? If yes, please specify on separate sheet.
Yes
No
Have you ever required medical treatment or counselling for drug or alcohol abuse? If yes, please provide details on separate sheet.
Yes
No
Do you hold a valid driving licence?
Yes
No
Do you smoke?
Yes
No
Do you drink alcohol? If yes, how much do you drink per week?
Yes
No
Name:
Signature:
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QuickTime™ en een -decompressor zijn vereist om deze afbeelding weer te geven.
References: Name
Function / Relation
Contact details
Thank you for taking the time to fill out this form. We are looking forward to receive your application.
Name:
Signature:
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