ACP Application Form

Note: This form was previously provided in the ACP Manual (9th edition). It will be revised and placed on the Transport Canada Forms Catalogue in the future. Insert required information prior to printing and submitting to Transport Canada.


 

Today's Date
(yy/mm/dd)

ACP Nominee

Name

 

Licence #

 

ACP Authority Requested:








Aircraft Types:

1) 

2) 

3) 

CAR (to be operated under)









Approved Check Pilot Course




Locations(s)

 

Date(s)
(yy/mm/dd)

 

Declarations

The following authorizes Transport Canada to publish a ACP’s name and phone number for the purpose of conducting flight checks.


 

Name


 

Signature

This certifies that the information provided in this application and the attached resume (for initial applications only) is accurate and that I will abide by the policies and procedures specified in the Approved Check Pilot Manual (TP 6533E).

 

Signature

 

Date(yy/mm/dd)

For Transport Canada use only

Inspector Verification:

Initial Authority:

The ACP Nominee

Revised Authority

Recommendation for Approval

Comments:

 

Inspector's Name

 

Signature

 

Date
(yy/mm/dd)

ACP Authority Approval:

Comments:

 

Issuing Authority

 

Signature

 

Date
(yy/mm/dd)

This approval supersedes and cancels the approval dated

 

 

Date(yy/mm/dd)

Date modified: