Flight Test FORM

This form must be complete for me to enter the required data to obtain an FAA approval for the test.

You must be signed off and “IN” IACRA prior to completing this form.

Applicants FULL Name

Applicants Certificate Number

Applicants FTN Number

Application ID Number

Phone

(###)

###

####

Check Ride Date selected

YYYY

Recommending Instructor Name

Recommending Instructor Phone Number

(###)

###

####

Recommending Instructor Certificate Number

Recommending Instructor E Mail Address

Name of Flight School

Flight School / Home Airport IATA code

Flight School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Part 61 or 141?

Aircraft to be used for Flight Test

Flight Test Aircraft N Number

Type of Exam

Initial Test, Retest or Discontinuance

Message