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AERO CHARTER, INC. PILOT APPLICATION
Personal Information
Date Completed _____/_____/_______
First Name ______________________M.I. ______ Last Name __________________________________
Primary Address ____________________________________City ___________________________ State _________Zip _________
Secondary Address __________________________________City ___________________________ State _________Zip _________
Phone Number _________________________________ Cell Phone Number __________________________
Gender (optional)
M or
F Email Address ______________________________ Earliest Availability_____/____/_______
Flight Experience
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
Total
Time
Last
90
days
Type of Operations
Last
12 Months
(mark with an X)
91
135
121
MIL
Multi-engine
and
Jet
Aircraft
All others
(A) TOTAL M.E.
(B)
Single-Engine Aircraft
Actual and Simulated Instrument
Cross-country
TOTALS (A + B)
Additional Flight Information
FAA Medical Certificate:
Aeronautical ratings:
q
q
q
First
q
q
CFII
q
q
ATP
CFI or Military Instructor
Type ratings, what aircraft?
-1-
Second
Commercial
q
q
q
CFI or Military Instructor
Third
Multi-engine
MEI
Ground Instructor
AERO CHARTER, INC. PILOT APPLICATION
Additional Flight Information (cont.)
Have you ever been grounded by the FAA or Military Authority? ______ 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? _______ if so, explain___________________________________________________________________________
____________________________________________________________________________________________________
Have you ever been cited for any violation of the FARs? _____ if so, explain_____________________________________________
___________________________________________________________________________________________________________
Have you ever been convicted of a DUI involving drugs and/or alcohol? ______ if so, explain________________________________
___________________________________________________________________________________________________________
Yes
No
Are you legally authorized to work in the United States?
Yes
No
May we contact your present employer
Yes
No
Are you willing to submit to an DOT drug and alcohol test?
Employment History
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 / End date ___/___/_____ to ___/___/_____
Employer type
91
121
135
Other _________________________________________
Address _________________________________________City __________________________ State__________Zip___________
Position ________________________________ If you are not currently employed, why? ___________________________________
Employer_________________________________________ Start date / End date ___/___/_____ to ___/___/_____
Employer type
91
121
135
Other _________________________________________
Address _________________________________________City __________________________ State__________Zip___________
Position ________________________________ If you are not currently employed, why? ___________________________________
Employer_________________________________________ Start date / End date ___/___/_____ to ___/___/_____
Employer type
91
121
135
Other _________________________________________
Address _________________________________________City __________________________ State__________Zip___________
Position ________________________________ If you are not currently employed, why? ___________________________________
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AERO CHARTER, INC. PILOT APPLICATION
Education History
High School/College/University _____________________________________________ Degree _____________________________
Address _________________________________________City __________________________ State__________ Zip___________
High School/College/University _____________________________________________ Degree _____________________________
Address _________________________________________City __________________________ State__________ Zip___________
Residence History (List the last 10 years if possible)
Address _________________________________________City __________________________ State__________ Zip___________
Start date / End date ___/___/_____ to ___/___/_____
Address _________________________________________City __________________________ State__________ Zip___________
Start date / End date ___/___/_____ to ___/___/_____
Address _________________________________________City __________________________ State__________ Zip___________
Start date / End date ___/___/_____ to ___/___/_____
-3-
AERO CHARTER, INC. PILOT APPLICATION
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 safetysensitive 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)
(Date)
___________________________________
(Print your name)
Mail this completed application to the following address:
Aero Charter, Inc.
Attn: Chief Pilot
501 Turbine Ave.
Chesterfield, MO 63005
-4-
