Reset Form

PRE-COURSE ASSESSMENT FORM

COURSE INFORMATION:
Start Date: 18 FEB 2017 Course Requested: ATR 72 RECURRENT TRAINING
Aircraft Type: ATR 42/72 Preferred CAE Training Location: Amsterdam
Self-Sponsored: YES NO Airline / Employer: HUNNU AIR

CLIENT INFORMATION:

Captain F/O Other :______ Male Female Nationality: MONGOLIA

First Name(s): GANPUREV Date of Birth: 26 NOV 1988

Surname: BOLDBAATAR ID / Passport: E 1442955
E-Mail: ganpurev@hunnuair.com Telephone No: (+976) 99974753
GERGE TOWER, CHINGGIS AVENUE 17 KHOROO 1, SUKHBAATAR DIS
Address:

LICENSE INFORMATION AND PREREQUISITES:

EASA State of License Expiry
Authority: MONGOLIA 27 SEP 2017
NON-EASA License Issue: Date:

CPL + ATPL Theory

License Number: ME/IR Expiry Date: 27 SEP 2017
ATPL

MCC Certificate If No: a minimum of 500 hours as a pilot in multi crew operations on aircraft or
(only required for Yes No
first type rating): helicopter is required.

ICAO English Level: 4 Medical Class 1 Expiry Date: 20 JAN 2017

FLYING HOURS AND TYPES ON LICENSE:

Total Flying Hours: Hours on Hours on Type

2,991 Current Type:
387 Requiring Renewal:

Flight Time Total Flying

527 2,726 Total Hours PIC: 182
Last 12 Months: Hours MPA:
A/C TYPE: Last Flight: Expiry of Last LPC/OPC:
ATR-72 4 FEB 2017 23 FEB 2017

Other qualifications currently held by client: SFI or TRI SFE or TRE

I understand that on the first day of training I will be required to present a valid license and medical class 1.
If this is my FIRST multi-engine multi-pilot type rating I will also be required to present a valid ME IR, MCC Course Completion Certificate or
equivalent and ATPL theory results.

Under the terms of the data protection act 1998, I understand that the above information will be kept strictly confidential in secure paper or
digital files for 3 years. It will be used by CAE personnel and may be disclosed to certifying authorities and can be used for the detection of
fraud.

Signature: ________________________________________________ Date: ______________________________

Received by (Full name in block capitals): Checked by (Full name in block capitals):
Reserved
for CAE

CAE CAE Pre-Course Assessment / Client Form

Training Process CAE DK/ATO/005
Electronic document, uncontrolled when printed Issue date: 10 Dec 2013