KISTAA/B-BOP/01-00/001

KIST AVIATION ACADEMY (KISTAA)

Applicant
Photo
(Passport Size)

APPLICATION FORM
KINDLY INDICATE THE COURSE YOU REQUIRE:
Private Pilot Licence (PPL) Course.
Commercial Pilot Licence with Instrument Rating (CPL/IR) Course.
Integrated Commercial Pilot Licence with Instrument Rating (CPL/IR) Frozen Airline
Transport Pilot Licence (ATPL) Course.
Assistance Flight Instructor (AFI)

A. PERSONAL DETAILS
1. Name

2. NRIC / MyKad / Passport No:

3. Nationality:

M - Malaysia

O Others: _____________________________

4. Address:

5. Telephone No.:
Home:
Mobile:

E-mail: ___________________________
6. Gender:

M- Male

F - Female

8. Marital Status:

S Single M Married

7. Date of Birth: (Example: 30-01-1982)

-

B. PARENT / GUARDIAN DETAILS

1. Name

2. NRIC / MyKad / Passport No:

3. Nationality:

M - Malaysia

O Others: _____________________________

4. Address:

5. Telephone No.:
Home:
Mobile:
Office:

6. Relationship to applicant: _____________________

E-mail: ___________________________

KISTAA/B-BOP/01-00/001

C. PREVIOUS FLYING EXPERIENCE

1. Hours Flown:

Solo ___________ hours

Dual ___________ hours

2. Licence held: (Please tick)

PPL
CPL/IR
ATPL

3. Ratings Held:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
4. Other Experiences:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

D. ACKNOWLEDGE

.
DATE : .

NAME:
NRIC / MyKad / Passport No:

DOCUMENTS REQUIRED:
Letter of approval from Department of Civil Aviation (DCA) Malaysia.
Medical Certificate (Class II for PPL Course and Class I for CPL/IR
and ATPL) from a DCA approved medical practitioner.
Certified true copies of academic qualifications.
Certified true copy of NRIC/MyKad or passport for Non-Malaysian citizens.
10 passports sized non-returnable colour photographs.

Post or fax this application form together with the accompanying documents to:
The Principal
KIST AVIATION ACADEMY
Sultan Mahmud Airport,
Lapangan Terbang Sultan Mahmud
21300 Kuala Terengganu
Terengganu, Malaysia.
or
The Registrar
KIST AVIATION ACADEMY
7A, Jalan P9G/7, Precint 9, 62250 Putrajaya
Tel: 03-88893323 Fax: 03-88905323