COMMUNITY-COMPASSION-COMMITMENT

Volunteer Pilots

Pilot information form

We’re glad you’re here.

If you have a MINIMUM of 300 hours as Pilot in Command and want to help us with our mission, please complete the form below and Jeff will contact you.

Personal Information

Name(Required)

First Middle Initial Last

Aircraft Registration

Address(Required)

Street Address Address Line 2 City Province Postal Code

Home Phone

Business Phone

Cellular

Fax Number

Email(Required)

Other Means of Contact

Sex

Marital Status

Date of Birth

Spouse/Partner's Name

First Last

Contact In Case of Emergency

Emergency Contact Name(Required)

First Last

Relationship(Required)

Emergency Contact Address(Required)

Street Address Address Line 2 City Province Postal Code

Emergency Contact Phone(Required)

Additional Data Angel Flight Should Be Aware Of:

Aviation Information

License Held:

Certificate #(Required)

Certificate Date of Issue(Required)

Private

Private Certificate Date of Issue

Commercial

Commercial Certificate Date of Issue

ATP

ATP Date of Issue

IFR

IFR Date of Issue

Night Rating

Night Rating Date of Issue

Class of Medical Held(Required)

Expiry Date of Medical(Required)

Restrictions on Medical

Has your license or medical certificate ever been revoked or suspended?(Required)

Yes

Please explain why your certificate was revoked or suspended.

Log Book Information

Day Hours(Required)

Night Hours(Required)

Multi Hours

IFR Hours - Air

IFR Hours - Sim

Total Hours

Hours in Last 12 Months(Required)

Hours in Last 3 Months(Required)

Hours in Last 28 Days(Required)

Aircraft Information

Aircraft Owned/Available for Angel Flight

Angel Flight Considerations

Insurance Details

Insurance Expiry Date

Amount of Coverage

Number of Seats

Home Airport

Mission Availability(Required)

When are you normally available for missions and how much notice do you required?

Signature(Required)

Form signature will be dated automatically when you submit this form.

COMMUNITY-COMPASSION-COMMITMENT

Volunteer Pilots

Pilot information form

We’re glad you’re here.

Personal Information

Contact In Case of Emergency

Aviation Information

Log Book Information

Aircraft Information

DONATIONS

Your Generosity. Our Mission.

BY CHEQUE

BY E-TRANSFER

CONTACT US

President & CEO

Director, Flight Operations

Director, Client Services

VOLUNTEER

Pilot Volunteers Welcome

Address

Angel Flight of British Columbia