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PILOT JOB APPLICATION FORM

PRIVATE & CONFIDENTIAL

Date:

A. PERSONAL PARTICULARS
Full Name: Current Address: Telephone Nos.: Date of Birth: New IC No.: Race: Height: House: Place of Birth: Old IC No.: Religion: Weight: Office: Mobile: Gender: Passport No.: Nationality: Health Condition:

B. FAMILY PARTICULARS
Marital Status: Name of Spouse: Occupation of Spouse: Fathers Name: Fathers Address: Employers Name: Fathers Occupation: Single Married Divorced Others (Please specify) ______________ No. of Children:

Mothers Name: Mothers Address:

Mothers Occupation:

No. of Siblings:

No. ____ in family

Pilot Job Application Form/rev1/16may07

C. ACADEMIC QUALIFICATIONS
Qualification 1. 2. 3. 4. University / College / School Year of Completion

D. EMPLOYMENT HISTORY
Employers Name & Address Position Held Year of Service From 1. To Reason for Leaving

2.

3.

4.

5.

E. LANGUAGE SKILLS
Language 1. English 2. Bahasa Malaysia 3. 4. Spoken Level of Fluency Written Level of Competency

F. ADDITIONAL SKILLS
Computer Knowledge: Driving Skills / Type of License: Other Skills: Vehicle Owned:

Pilot Job Application Form/rev1/16may07

G. LICENSE / CERTIFICATIONS
Type CPL ATPL Medical License No. Issuing Authority Valid From Date Valid Till Date

H. ENDORSEMENTS / RATINGS
Type Authority Date Endorsed

I. OTHER INFORMATION
1. Have you ever been involved in any aviation related incident/accident in your flying career? If YES, please state.

2. Other Information:

J. FLYING EXPERIENCE
P1 Single Engine Multi-Engine Jet Total Hours P1US P2 Grand Total Hours

Pilot Job Application Form/rev1/16may07

K. OTHER INFORMATION
1. Were you previously employed by AirAsia? If YES, state position held, date / duration of service and reason for leaving. 2. Have you ever been discharged from any previous employment due to misconduct? If YES, please state. 3. Have you ever been arrested for violation of any law / convicted of any crime? If YES, state nature of violation and date. 4. Are you serving any bond with anybody? If YES, please state. 5. Have you had any illnesses or suffered any injury? If YES, please state. 6. Would you be willing to perform overtime or shift duties should the need arise, especially the night shift?

L. REFERENCES
Name: Designation: Address: Name: Designation: Address:

Telephone No:

Telephone No:

M. STATEMENT OF DECLARATION
I hereby declare that: I have not been convicted of criminal offence or been declared bankrupt in any country. The particulars in this application form and document(s) attached hereto are true in every respect. I have not willfully suppressed any material fact. I understand if any particulars supplied by me in this form are proved untrue, I am liable to be summarily dismissed.

Applicants Signature: _______________________________________________ FOR OFFICE USE ONLY Interview Result: Designation Job Grade Basic Salary Date of Appointment Remarks: Hire KIV Reject Allowance/s 1. 2. 3.

Date: ________________________

Interview Date: Amount

Interviewed By: 1. 2. 3.

Verified By:

Approved By:

Director, Flight Operations Date:

CEO/CFO Date:

Pilot Job Application Form/rev1/16may07