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CA-9 (PILOT):

Rev. Aug. 06

APPLICATION FORM FOR PILOTS EXAMINATION (GEN & TECH)

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1. * COMPUTER NO.

2. SESSION

3 FEES: @ Rs.500/- per paper on a SINGLE DRAFT payable to PAO, DGCA,MCA ,New Delhi

P-
P-
on a SINGLE DRAFT payable to PAO, DGCA,MCA ,New Delhi P- M M Y Y Y
on a SINGLE DRAFT payable to PAO, DGCA,MCA ,New Delhi P- M M Y Y Y
on a SINGLE DRAFT payable to PAO, DGCA,MCA ,New Delhi P- M M Y Y Y
on a SINGLE DRAFT payable to PAO, DGCA,MCA ,New Delhi P- M M Y Y Y
on a SINGLE DRAFT payable to PAO, DGCA,MCA ,New Delhi P- M M Y Y Y

M

M

Y

Y

Y

Y

Details of fee attached :

Amount Rs……………… DD No………………

Issue branch………… ……………………….Dtd……….

* If computer number NOT filled, the application will NOT be accepted.

4.

NAME:

 

5. Exam. CENTRE:

6.

Details of Category of Lic and papers, the applicant desires to appear:

of Lic and papers , the applicant desires to appear: (a) CATEGORY of Lic. * PPL/

(a) CATEGORY of Lic.

*

PPL/CPL / CHPL / ATPL / CPLCG/ / ATPLCG …etc.) Fill only one Cat. in this box

(b) Do you desire to appear in PPLG composite paper* also. YES / NO:

………

* If you are appearing for the first time in this Category, enclose duly filled in Annexure-1

i) General Papers desired to appear (fill the appropriate boxes given below with YES/NO ):

Navigation

Meteorology

Regulation

Radio aids & Inst

Composite

ii) Technical Papers : (write YES / NO in the following blocks):

Tech. Gen(P -1)

Specific ( P-2)#

Performance( P-3)#

Name of Aircraft with model for P-2/P-3

#Submit course completion certificate, if appearing in paper-2 (Specific) on any of the aircraft including Performance Completion Course, if appearing on heavy aircraft . Defence candidates may enclose Commander Certificate.

7. Details of valid Indian Licenses held ( SPL /PPL /CPL/ ATPL /CHPL)……………… Licence Number… ……….Validity…………

8. Total Hours Flown :………….Hrs.…………….Mts

9. Name and address of DGCA approved Flying Training institute: ……………………………………………………………………

10. Name and address of DGCA approved Ground Training Institute:…………………………………………………………………

……………………………………………………………………………………………………………………………………………

11. For CONVERSION to Indian license, furnish details of Foreign Pilots license already held Category…………Licence No ………

Country of issue…………………

12. Date of Birth: ………………………

Validity ………………………….

(Enclose attested copy)

13. Tel/ Mobile No.: ……………

NOTE:- CHANGE IN MAILING ADDRESS , if any, should be intimated SEPARATELY & not to be written in this application.

14. Details of last two examinations attempted by the candidate:

Session

Roll No.

Subjects

Cat.

Nav /

Met.

Reg,

Rad. &

Tech.P1

Tech.P2

Tech.

appeared

Comp

Inst.

P3

   

Marks

               

obtained

   

Marks

               

obtained

I hereby declare that the above particulars are true in every respect and that nothing has been concealed or withheld by me. If any of my statements are found false at any time, my candidature may be rejected. I have read and understood the requirements for issue of Pilots License, and the

instructions for appearing in examinations.

License, and the instructions for appearing in examinations. Date: ……… Signature of applicant Note: - 1.

Date: ………

Signature of applicant

Note: - 1. The Last date of submission of this application for each Session is displayed on DGCA Website: http://dgca.gov.in 2. List of admitted candidates will be displayed on DGCA website three weeks prior to the date of written examination. 3. Mobile Phones are NOT permitted in the

Examination hall. 4.

Display your Photo Identity Card during the entire period of examination. 5. No application should be forwarded one month

prior to the last date of of that session of examination.

NOTE :

Annexure-1

CA-9 (PILOT):

Rev. Aug. 06

THIS ANNEXURE IS ALSO REQUIRED TO BE FILLED UP ALONG WITH CA-9 (PILOT) FORM WHENEVER APPEARING FIRST TIME IN PPL OR CPL OR ATPL EXAMINATION

1. Computer Number:

TIME IN PPL OR CPL OR ATPL EXAMINATION 1. Computer Number: 2. Name of applicant:

2. Name of applicant: ……………………………………………………………

3. Date of Birth: ………………

4. Educational Qualification ………………………….

NOTE:

Enclose the attested copy of Marks-sheet of 10+2 with Physics & Mathematics in case the applicant has acquired this qualification after allotment of computer number.

5. Category of Licence, applicant desires to appear: ……………

6. Details of Pilots’ Licence already held by the applicant:

(i)

Category of Licence: ……………

(ii) Lic. No.: ………………

(iii) Validity: …………………….

(iv)

Is the CPL endorsed for Multi-engine Rating, YES / NO:……………

(v) If yes, name of the

aircraft…………………. (Enclose the attested copy of the Licence).

7. Name and address of the DGCA Approved Ground Training

Institute:………………………………………………………….

……………………………………………………………………………………………………………………………………

……

8.

Details of Flying:

(a) Total Flying Hours :

Hrs ………………Mts ………………

(b) Flying Hours as PIC: Hrs …………….

Mts …………………

Note: Enclose attested copy of the last page of the pilot Log book containing the summary of flying hours duly certified by the PII or Commanding Officer , This page should bear the name and date of birth of the pilot or pilot trainee.

Date :

CERTIFICATE

Signature of applicant

Certified that Mr./ Ms ……………………………………………attended classes for the ground subjects at the above mentioned Institutes and further certified that he / she has flying experience, as mentioned above.

Place:

Date:….

SEAL

Signature of PII / DGM (Ops.)/ Commanding Officer

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