HELIGO CHARTERS PVT.LTD

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PILOT APPLICATION FORM

Surname/Family Name*

First Name*

Other Names*

Date Of Birth*

Place/Country Of Birth*

Postal Address*

E-Mail Address*

Telephone Number*

Residential Address*

Mobile*

Work (If Acceptable)

Upload Resume

Nationality

Country Of Issue

Place Of Issue

Passport Number

Date Of Issue

Date Of Expiry

Height (Inches/Cms)

Weight (Lbs/Kgs)

Colour Of Eyes

Any Scars, Tattoos Or Distinguishing Marks?

Present Occupation	Notice Period Required	Name And Address Of Present Employer*

Time In Post	Contact No	Can We Approach Your Present Employer For A Reference? Please Show Contacts.

What Is The Earliest Date You Will Be Available?		Country

Instrument Rating
Type: (- Single, Twin, Icao, Military, Restricted, Military Unrestricted, Faa)	Date Of Last Ir Test & Helicopter Type	Total Instrument Time (Helicopters)

Do You Hold A Valid Class 1 Medical?		If Yes: Expiry Date:
Country, Place & Date Of Issue:
Do You Wear Glasses Or Contact Lenses?		If Yes: Are They For: Distance / Bifocal Or Contacts Lenses?
List Any Medical Restrictions:

Has Any Licence (Above) Or Medical Ever Been Revoked, Cancelled Or Suspended (If Yes, Give Details Below):