Test Date & Time: No dates? --Please Select-- -- No Dates Available - Check Back Later -- Checkride Type: --Please Select-- Private - Airplane Single Engine Land ($850.00) Private - Airplane Multiengine Land ($850.00) Private - Remove Multi VFR Only Limit ($300.00) Private - Remove Multi Center Thrust Limit ($300.00) Instrument Airplane ($850.00) Commercial - Airplane Single Engine Land ($850.00) Commercial - Airplane Multiengine Land ($850.00) Commercial - Remove Multi VFR Only Limit ($300.00) Commercial - Remove Multi Center Thrust Limit ($300.00) Is training complete now? Why this? No - DO NOT SCHEDULE Yes IACRA/Endorsements done? Why this? No - DO NOT SCHEDULE Yes Initial or Add-on? What's this? --Please Select-- Original Certificate Add-on Rating Location (Airport): --Please Select-- KJWN KLUG KMBT KMQY M54 First name
Last name
Phone Number: Address: City: State: Zip: Email: Current Certificate: --Please Select-- Student Pilot Recreational Pilot Sport Pilot Private Pilot Commercial Pilot Air Transport Pilot Flight Instructor Certificate Number: Certificate Date (MM/DD/YYYY)
FTN: What's this? Medical Type: --Please Select-- 1st Class 2nd Class 3rd Class BasicMed None Medical Date (MM/DD/YYYY)
Age When Medical Obtained Under 40 years 40 years or more CFI First name
CFI Last name
CFI Phone Number: CFI Email: CFI Certificate Number: Supervisor Email (Optional) What's this?: FAR Part: 61 141 Aircraft Model: Tail Number: Flight School: Is this a Retest?: No Yes Comments: