Check Ride Intake Sheet 2020
Do not complete unless you have scheduled your Check Ride with me. If you have, please fill out this form to make your Check Ride process more efficient. Use the email that it sends you to keep your information updated. Thank you!
Email address *
Check Ride Type *
If Part 141, Include Date on Graduation Certificate
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Rating *
For Flight Instructors Only - Is this your "Initial" "Renewal" or an "Add-on"?
Your answer
Application Information
Name (Last, First, Middle) *
Your answer
Current Certificates/Rating Held (Includes Student Pilot Certificate) Please include your Pilot/Student Pilot Certificate number. *
Your answer
CFI Endorsement & IACRA Completed *
Required
CFI Endorsement / IACRA Completion Date
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DD
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YYYY
Current Address, to include Street Address, City, State, & Zip Code *
Your answer
Phone (home or cell) *
Your answer
IACRA FTN
Your answer
Knowledge Exam Date (If applicable)
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DD
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YYYY
Knowledge Exam Grade (If applicable) *
Your answer
Flight Training Facility *
Training Facility (if Other Include City and State)
Your answer
Instructor Information
Instructor's Name (Last, First) *
Your answer
Instructor Phone (home or cell) *
Your answer
Instructor's CFI Certificate Number & E-Mail *
Your answer
Practical Test (Check Ride) Information
Requested Date *
MM
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DD
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YYYY
Retest (If "YES", Complete a new IACRA 8710 and get your Instructors to Retrain and Endorse you for the Retest. *
Notice of Disapproval Date (if Retest)
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DD
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YYYY
DPE’s Name, Location - City and State (If Notice of Disapproval)
Your answer
Letter of Discontinuance *
Letter of Discontinuance Date (If Letter of Discontinuance)
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DD
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YYYY
DPE's Name, Location - City and State (If Letter of Discontinuance)
Your answer
Aircraft to be used (Make, Model & "N" number): *
Your answer
GPS Database Current *
iPad Database Current *
Location for Check Ride (Airport's 3 Letter ID) and Include Cross Country (If applicable) after I assign it. Also, include the time we agreed to meet. *
Your answer
A copy of your responses will be emailed to the address you provided.
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