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Instructor's Training Record While Under Direct Supervision

Name: ____________________________________ 5802 - ______________

Address: _______________________________________________________

Telephone Number: ________________   Licence Number: ______________

Instructor Rating Held:  Aircraft Category _____________Class ___________

I have conducted 50% or more of the last 10 hours of the dual flight instruction for the following applicants, each of whom, upon my recommendation, demonstrated the required standard of skill and knowledge for first solo flight and for the flight test for issue of a licence.

Section 1 — FIRST SOLO FLIGHT — DAY VFR

Date Students Name and Licence/Permit Number Name of School or Club Supervising Instructor's Signature & Licence Number

1. _____________________________________________________________

2. _____________________________________________________________

3. _____________________________________________________________

Section 2 — STUDENTS RECOMMENDED TO UNDERTAKE THE FLIGHT TEST FOR ISSUE OF A LICENCE

Date Students Name and Licence/Permit Number Name of School or Club Supervising Instructor's Signature & Licence Number

1. _____________________________________________________________

2. _____________________________________________________________

3. _____________________________________________________________

This record is in support of my application for the issue of a Class 3 Instructor
Rating — _____________________________ Category.
                 (aeroplane, helicopter, etc.)

Signature of Applicant ____________________________Date: ____________

This is to certify that __________________________ has conducted
100:00 hours dual flight instruction and it is recommended that a Class 3 ________________________Flight Instructor Rating be issued.
    (aeroplane/helicopter)

Name: _________________ Licence no: _____________ Date: ___________

Checked and Recommended Issue

Date: ___________________________  For RMAL: _____________________

Date modified:
2010-05-21