(TO BE FILLED IN BLOCK LETTERS & TICK THE APPROPRIATE BOX) [5 Private PILor LICENCE © Grounp raining Q FLyING oN COMMERCIAL PILOT LICENCE: (C) GROUND TRAINING (C) FLYING [5] ASSISTANT FLIGHT INSTRUCTOR RATING] INSTRUMENT RATING AIRLINE TRANSPORT PILOT LICENCE (J SIMULATOR FLYING To, [OJ AIRCRAFT MAINTENANCE ENGINEERING (AIRFRAME & ENGINE) THE BOMBAY FLYING CLUB [7 aigCRART MAINTENANCE ENGINEERING AVIONICS MUMBai 400 008 Co caBIN CREW TRAINING mn SURNAME TIRSTNAME MIDDLENAME INFULL FATHER'S! HUSBANDS NAME SEX | MALE FEMALE NATIONALITY AFFIX A RECENT DATE OF BIRTH , 5 MARITALSTATUS | M uM PHOTOGRAPH "ADDRESS FOR COMMUNICATION PERMANENT ADDRESS PIN TEL. PIN TEL. CONTACT IN CASE OF EMERGENCY] Name RELATION, ADDRESS TEL, EDUCATIONAL LEVELS (INDICATE FROM X ONWARDS) COURSE ‘UNIVERSITY / HOARD" SUBIECTS YEAR| % 70 BE FILLED BY AVIATION BACKGROUND CANDIDATES, EX-SERVICEMEN SERVING DEFENCE & CIVIL AVIATION PERSONAI. NAME & ADDRESS OF COMPANY TEsenaTION | MEMBERSHIP OF ANY AVIATION ORGANISATION & THE CATEGORY OF MEMBER There by confirm that Information furnished above is correct and I understand that giving wrong information makes me ineligible for admission. 1 assure that I will abide by all rules of The Flying Club and ammendments to that effect in future. Parent's / Guardian's Signature Date Signature of Candidate Attach the 1. TWO RECENT PASSPORT SIZE PHOTOGRAPH. following : 2. ATTESTED XEROX COPIES OF DATE OF BIRTH & EDUCATIONAL QUALIFICATIONS. USE ON ‘TOTAL TUTION FEE PAID DATE, BALANCE PAID DATE RECEIPT NO. STUDENT NO. BATCH TIMINGS COMMENCEMENT DATE [COMPLETION DATE| APPROVED BY