PILOT ASSESSMENT FORM T3

IT IS MANDATORY FOR TRAINERS TO FILL THIS FORM FOR ALL ASSESSMENTS / CHECKS
FLEET: ATR B737 A330 B777 DATE : DD/MM/YY

AEROPLANE
SEAT OCCUPIED CREW STATUS
LHS / RHS P1 / P2 / U/T P1 / U/T P2
SIMULATOR LEVEL: D

NAME FLYING LICENCE NO / STAFF NO.

EXPERIENCE FATA NO.
TOTAL ON TYPE

PILOT UNDER
CAPT
TRAINING
CO-PILOT
TRAINER CAPT

TYPE OF
CHECK

NOTE:
1. GRADE 1 OR 2 IN ANY COMPETENCY DOES NOT MEET PROFICIENCY STANDARD. THE
COMPETENCY DEFICIENCIES INDICATORS GIVEN ON NEXT PAGE MUST BE APPROPRIATELY
TICKED [  ] TO SUPPORT EVALUATION, DEBRIEF AND RE-TRAINING, FOLLOWED BY AN EMAIL TO
fltopstrgdelivery@jetairways.com
2. IN CASE OF GRADE 3, IT IS RECOMMENDED TO FILL THE ADDITIONAL COMMENTS SECTIONS TO
SPECIFY THE AREAS OF IMPROVEMENT.
GRADING SCALE []
NO. COMPETENCIES
1 2 3 4 5
1) Knowledge
2) Application of Procedures
3) Flight Management Skill – Automation
4) Aircraft Handling Skill – Manual
5) Communication

6) Teamwork and Leadership

7) Situation Awareness
8) Decision Making
9) Workload Management

Overall Assessment: SATISFACTORY / UNSATISFACTORY

5 - Commendable Excellent performance, Safety standard are enhanced and errors are rare

4 - Expected Standards Good performance, Safety standards are maintained and minor errors committed

3 - Acceptable Standards Adequate performance, Safety standards are within margin and errors are managed

Performance needs Improvement, Safety is compromised and errors are

2 - Marginal
mismanaged.

1 - Unacceptable Performance is below standard, Unsafe and errors are undetected.

DOC No: JA/OPS/083 PAGE 1 OF 2 (P&S) REV - 7.0 / 01 OCT 2015

 PILOT ASSESSMENT FORM T3

NO. COMPETENCY COMMON DEFICIENCY INDICATORS

1) Knowledge System Performance Procedures NP/ OM

2) Application of Procedures Visual Non-precision Precision Maneuvers

Inappropriate Inadequate use

3) Flight Management Skill Over Reliance Poor Monitoring
Mode of Automation
Thrust / Power
Over/ Under
4) Aircraft Handling Skill Poor trim technique Lever Poor Scan
controlling
Management
Non-standard
Non-Attentive Lack of Briefing /
5) Communication RT / Clarity of
listener Assertiveness Callouts / PA
Speech
Weak Ineffective Inappropriate use Fails to
Causes
6) Teamwork/ Leadership support and of Authority / implement
Distraction
monitoring duties Non-receptive *PACE
Gathers limited Fails to identify Fails to plan for Lack of
7) Situation Awareness
data errors contingency anticipation

No knowledge of Unable to identify

8) Decision Making Indecisive Hurried
*CLEAR Model resources
Unable to
Unable to Manage Gets distracted
9) Workload Management Assimilate Fixated
Time easily
Information
*P-A-C-E Probe – Assert – Caution - Exert Authority

*C-L-E-A-R Clarify - Look for options – Evaluate – Act – Review

Additional Narrative Comments.

DEBRIEFED

PILOT UNDER CHECK’S SIGNATURE TRAINER SIGNATURE

FOR OFFICE USE

RECEIVED CHECKED PROCESSED FILED
DEPT. RECORDS FOR TRAINING DELIVERY LICENCING UPDATE RECORDS

NAME

SIGN

DATE

DOC No: JA/OPS/083 PAGE 2 OF 2 (P&S) REV - 7.0 / 01 OCT 2015