Pilot Application

Step 1 of 7 - Personal Information

14%

Name*
First Last
Primary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number
Mobile Phone
Email
Gender
- Male
- Female
Earliest Availability
Date Format: MM slash DD slash YYYY

Multi-engine and Jet Aircraft
Do not include Helicopter, Flight Simulator, or Flight Engineer time in these totals. Military applicants should use a conversion factor of 1.3 for every hour flown in the various categories listed below. Simply multiply the hours flown by 1.3 and enter that number in the appropriate fields. Please list the most current aircraft that you are flying or have flown first.
Make and Model of Aircraft
Position
- PIC
- SIC
Hours
Total in 90 Days
Total in 12 Months
Total Hours
Type of Operations
- 91
- 135
- 121
- MIL
Add another Multi-engine?*
- Yes
- No
Make and Model of Aircraft
Position
- PIC
- SIC
Hours
Total in 90 Days
Total in 12 Months
Total Hours
Type of Operations
- 91
- 135
- 121
- MIL
Add Another Multi-engine*
- Yes
- No
Make and Model of Aircraft
Position
- PIC
- SIC
Hours
Total in 90 Days
Total in 12 Months
Total Hours
Type of Operations
- 91
- 135
- 121
- MIL
Total Multi-engine
Single-Engine Aircraft
Position
- PIC
- SIC
Hours
Total in 90 Days
Total in 12 Months
Total Hours
Type of Operations
- 91
- 135
- 121
- MIL
Actual and Simulated Instrument
Position
- PIC
- SIC
Hours
Total in 90 Days
Total in 12 Months
Total Hours
Cross-country
Position
- PIC
- SIC
Hours
Total in 90 Days
Total in 12 Months
Total Hours

Additional Flight Information
FAA Medical Certificate:
- Select All
- First
- Second
- Third
Aeronautical ratings:
- ATP
- Commercial
- Multi-engine
- CFI or Military Instructor
- CFII
- MEI
- Ground Instructor
- Type ratings, what aircraft?

What Aircrafts

Have you ever been grounded by the FAA or Military Authority?*
- Yes
- No
If Yes, explain:
Have you been involved in any accident or incident resulting in injury or death of passengers/crew members or damage to an aircraft?*
- Yes
- No
If Yes, explain:
Have you ever been convicted of a DUI involving drugs and/or alcohol?*
- Yes
- No
If Yes, explain:
Are you willing to submit to an DOT drug and alcohol test?*
- Yes
- No

Employment History
Are you legally authorized to work in the US?*
- Yes
- No
May we contact your present employer*
- Yes
- No
Please list your most recent employer first, and so on. At a minimum, please list all aviation related employers that you have worked for. You may attach another sheet if there is insufficient room on this form.
Employer
Start Date
Date Format: DD slash MM slash YYYY
End Date
Date Format: DD slash MM slash YYYY
Employer Type
- 91
- 121
- 135
- Other
Position
If you are not currently employed, why?
Employer
Start Date
Date Format: DD slash MM slash YYYY
End Date
Date Format: DD slash MM slash YYYY
Employer Type
- 91
- 121
- 135
- Other
Position
If you are not currently employed, why?
Employer
Start Date
Date Format: DD slash MM slash YYYY
End Date
Date Format: DD slash MM slash YYYY
Employer Type - 3
- 91
- 121
- 135
- Other
Position
If you are not currently employed, why?

Education History
High School/College/University
Degree
Address
Street Address City State / Province / Region ZIP / Postal Code
High School/College/University
Degree
Address
Street Address City State / Province / Region ZIP / Postal Code

Residence History
Address
Street Address City State / Province / Region ZIP / Postal Code
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY
Address
Street Address City State / Province / Region ZIP / Postal Code
Start Date
Date Format: MM slash DD slash YYYY
End Date
Date Format: MM slash DD slash YYYY

Terms and Conditions
Pre-employment Inquiry Authorization Release: In connection with my application for employment, continued employment or promotion, I understand and agree that background inquiries may be requested by Aero Charter, Inc. that will seek information as to my character and work habits, including oral assessments of my job performance, experience and abilities, along with the reasons for termination of past employment. Further, I understand and agree that Aero Charter, Inc. may request information from various federal, state and other agencies, including public and private sources that contain records concerning my past activities related to my driving record, credit history, criminal record, civil inquiries, and other experiences. Pilot candidates will also be requested to provide medical information in compliance with Federal Aviation Regulations as necessary. I acknowledge that a telephonic facsimile or copy of this release shall be as valid as the original. This release is valid for all federal, state, county, and local agencies and authorities.

Terms of Employment: I authorize investigation of all statements contained in this application and certify that this information is true and correct, and release all parties from all liability for the damage that may result from this investigation. I understand that at all times, the manufacture, use, sale, possession, distribution, or transfer of illegal drugs, controlled substances, or unauthorized use of alcohol on premises is strictly prohibited and that failure to comply will result in termination. I understand that misrepresentation or omission of facts called for is cause for immediate dismissal without recourse. As part of Aero Charter, Inc. policy applicants are required to undergo drug testing to determine the presence of marijuana, cocaine, opiates, phencyclidine (PCP) and amphetamines, any substance listed in schedule I or II of the Controlled Substance Act, or a metabolite of these drugs in my system. I understand that if I test positive in accordance with pre-employment anti-drug procedures, no offer of employment will be made, and any offer of employment that I may have received, for any position, will be considered withdrawn. In the event that a “negative dilute” specimen is received, I will be required to immediately retake the test. Failure to do so as instructed will be considered a voluntary withdrawal in the application process and I will no longer be considered for employment. I also understand that if I test positive at any time, my employment will be terminated. If I apply, or transfer into a "safety-sensitive" position as defined by the U.S. Department of Transportation, I will be required to answer specific drug and alcohol related questions regarding my past safety-sensitive employers, or past safety sensitive positions applied for and authorize the records of applicable previous employers to be released to Aero Charter, Inc. If employed by Aero Charter, Inc., and if by the definition of my position, or a work-related situation deems it necessary, I understand that I will also be subject to random testing, reasonable cause/suspicion, post-accident, post-mishap/unsafe action, return-to-duty and follow-up testing as applicable for the drugs listed above and/or alcohol testing. I fully understand that any falsification or omission of information requested during my employment process will constitute grounds for failure to hire or for dismissal. If accepted for employment or training, I agree to abide by all present and future guidelines of Aero Charter, Inc. both with respect to work performance and standards of personal conduct. If employed, I understand that my employment is for an indefinite period of time and that my employment may be terminated at any time for any reason. I understand that completion of this employment application form does not constitute any type of employment agreement or contract. I understand that I am required to comply fully with all personal identification and employment eligibility requirements of the Immigration Reform and Control Act and that failure to do so will result in termination. All right, title, and interest, including without limitation, all copyrights and patents, in and to any material produced or inventions developed by me which affect or relate to Aero Charter, Inc.'s business or affect or relate to the charter industry shall vest in Aero Charter, Inc. and I shall have no personal right, title, or interest whatsoever therein.
By signing below, I agree to all terms previously reviewed
Sign Your Name*
(Print your name)
Signature Date*
Date Format: MM slash DD slash YYYY
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