SKILL TEST PPL(A) AEROPLANE SE ME Application and ... - DMU

SKILL TEST PPL(A) AEROPLANE SE ME
Application and Skill Test form
A. Udfyldes af ansøgeren/To be completed by the applicant:
CPR-nr./Date of Birth: Certifikat nr/Licence no: (If any) Udstedende Stat/State of Licence Issue:
Fornavne/First name(s):
Efternavn/Last name:
Gade eller vej:/Street:
Postnr. Og by/Postal code and city: E.mail: Tlf./Telephone:
Dato for underskrift/Date of signature
Underskrift/Signature:
B: Udfyldes af skolen/To be completed by FTO/Reg. Fac.:
Name of FTO/Reg.Fac.: (Use stamp):
Specification of flight time obtained during training
Total: Dual: Solo: FNPT or sim:
Number of hours reduced Helicopter: Glider: Selfsustaining glider: Microlight:
due to credit of flight time
in other aircraft:
I hereby certify that the applicant has passed the required training and that the applicant fulfils the requirement for the issue of Private Pilot
Licence (aeroplane)
Date of signature of Head of Training
Signature of Head of Training
C: To be completed by the Examiner:
Date of test: Licence Endorsement: Type of aircraft:
Name of Examiner or stamp:
Stamp of Examiner;
Authorisation no. of Examiner or stamp:
Section 1:
Section 2:
Section 3:
Passed Failed Passed Failed Passed Failed
Final result:
Passed Partial Pass Failed
Result of the test
Section 4:
Section 5:
Passed Failed Passed Failed
Temporary licence issued (copy enclosed):
Yes No Valid until:
Section 6:
Not Applicable
Passed Failed
D: For official use:
File nr:_________________
T-system:______________ Fee:_________
PPL(A) can be issued: Yes No Licence Endorsement:_____________________________
Skill_Test_PPL_A_feb2011 Page 1 of 4
Trafikstyrelsen, P.O. Box 744, DK-2450 København SV. Telephone: +45 36 18 60 00. Fax +45 36 18 60 31.

For detailed items read Appendix 1 & 2 to JAR-FCL 1.135
Name of Applicant:
SECTION 1 PRE-FLIGHT OPERATIONS AND DEPARTURE
Passed Failed
a
b
c
d
e
f
g
h
Pre-flight documentation and weather brief
Mass and balance and performance calculation
Aeroplane inspection and servicing
Engine starting and after starting procedures
Taxiing and aerodrome procedures, pre take-off procedures
Take-off and after take-off checks
Aerodrome departure procedures
ATC liaison – compliance R/T procedures
SECTION 2 GENERAL AIRWORK
Passed Failed
a
b
c
ATC liaison – compliance R/T procedures
Straight and level flight, with speed changes
Climbing
i. Best rate of climb
ii.
iii.
Climbing turns
Levelling off
d
e
f
g
Medium (30° bank) turns
Steep (45° bank) turns (including recognition and recovery from a spiral dive)
Flight at critically low airspeed with and without flaps
Stalling
i. Clean stall and recover with power
ii.
iii.
Approach to stall descending turn with bank angle 20°, approach configuration
Approach to stall in landing configuration
h
Descending
i. With and without power
ii.
iii.
Descending turns (steep gliding turns)
Levelling off
SECTION 3 EN-ROUTE PROCEDURES
Passed
Failed
a
b
c
d
e
f
g
Flight plan, dead reckoning and map reading
Maintenance of altitude, heading and speed
Orientation, timing and revision of ETAs, log keeping
Diversion to alternate aerodrome (planning and implementation)
Use of radio navigation aids
Basic instrument flying check (180° turn in simulated IMC)
Flight management (checks, fuel systems and carburattor ice, etc.) ATC liaison – compliance R/T procedures
Skill_Test_PPL_A_feb2011 Page 2 of 4

For detailed items read Appendix 1 & 2 to JAR-FCL 1.135
Name of Applicant:
SECTION 4 APPROACH AND LANDING PROCEDURES
Passed Failed
a
b
c
d
e
f
g
h
Aerodrome arrival procedures
∗ Precision landing (short field landing); cross wind, if suitable conditions available
∗ Flapless landing
∗ Approach to landing with idle power (SINGLE ENGINE ONLY)
Touch and go
Go-around from low height
ATC liaison – compliance R/T procedures
Actions after flight
a
b
c
d
e
SECTION 5 ABNORMAL AND EMERGENCY PROCEDURES
(This section may be combined with sections 1 through 4)
Simulated engine failure after take-off (SINGLE ENGINE ONLY)
∗ Simulated forced landing (SINGLE ENGINE ONLY)
Simulated precautionary landing (SINGLE ENGINE ONLY)
Simulated emergencies
Oral questions
Passed
Failed
a
b
c
d
e
f
SECTION 6 SIMULATED ASYMMETRIC FLIGHT AN RELEVANT CLASS/TYPE ITEMS
(This section may be combined with sections 1 through 5)
Simulated engine failure during take-off (at a safe altitude unless carried out in a flight simulator)
Asymmetric approach and go-around
Asymmetric approach and full stop landing
Engine shutdown and restart
ATC liaison – compliance R/T procedures, Airmanship
As determined by the Flight Examiner – any relevant items of the class/type rating skill test to include, if applicable:
i. Aeroplane systems including handling of autopilot
Passed
Failed
ii.
iii.
Operation of pressurisation system
Use of de-icing and icing system
g
Oral questions
∗ Some of these items may be combined at the discretion of the Flight Examiner
Skill_Test_PPL_A_feb2011 Page 3 of 4

For detailed items read Appendix 1 & 2 to JAR-FCL 1.135
Name of Applicant:
Details of the flight
Destination aerodrome On block On ground
Departure aerodrome Off block Airborne
Aircraft registration Total block time Total airborne time No. of landings:
Remarks/Overall assessment/Reasons for failure (if applicable):
Name of instructor present at the Skill Test:
Signature of Examiner:
Signature of applicant:
Skill_Test_PPL_A_feb2011 Page 4 of 4