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You MUST use this guide in conjunction with the clear and concise instructions published by the FAA on page two of the 8710-1 Airman Certificate and/or Rating Application.                You can only apply for one rating or license on each 8710-1. I.E; a multi engine commercial and instrument flight test requires two 8710-1s.
 Do not mark section I. until you meet with the examiner.  
                                          Airman Certificate and/or Rating Application Guide
I.Application Information    0Student      0Recreational       0Private     0Commercial      0Airline Transport     0Instrument
0Additional Rating 0Airplane Single-Engine 0Airplane Multiengine 0Rotorcraft   0Balloon 0Airship 0Glider 0Powered-Lift
0Flight Instructor___initial___Renewal___Reinstatement  0Additional Instructor Rating  0Ground Instructor 0 Other_______
A.         Name (Last, First, Middle)
Smith, Robert Paul 
You must use only ONE middle name if you have any at all. If you don’t have one you MUST Insert NMN after your first name. You can not indicate NMN if you have a middle name.
B.         SSN (US Only)
 
If not a US citizen, you MUST write
        NONE.
C.                 Date of Birth
            Month     Day      Year
12   /   25 /    2009
MONTH/DAY/YEAR
   Numbers ONLY.
D.         Place of Birth
Birmingham, United Kingdom
City and Country
E.         Address
House number & street name
Do not use a house name or post box unless you have also provided an extremely clear map on a separate sheet of paper to your residence. IF YOUR RESIDENCE HAS NO HOUSE NUMBER,YOU MUST PROVIDE A DETAILED MAP.
F.         Citizenship                                Specify
 
Tick the applicable box. If not USA, write nationality below.
0USA     0Other_____________
G.        Do you read, speak, write & understand the English language
Failure to fill this application out in accordance with these & the FAA’s incredibly clear & concise instructions on page 2 of the 8710-1 application may be an indication of a lack of English Proficiency! This could be a show stopper!
          0Yes      0No
City, State, Zip code
City, State or Province, Post code & COUNTRY i.e; Norwich, Norfolk NR6 6EG, United Kingdom.
H.        Height
In inches only. Round off to the next nearest number. Do not write  " or inches after the number. 6 feet 2 inches is written as     74
I.          Weight
Pounds
 ONLY.
 
185 Pounds
Is written as 185
J.          Hair
Bald
Black
Red
Brown
Blond
Gray
These are the ONLY CHOICES & you may only select one!
K.Eyes
Blue
Brown
Black
Hazel
Green
Gray
These are the ONLY CHOICES & you may only select one!
L.Sex
 
0Male
0Female
 
Tick one.
M. Do you now hold, or have you ever held an FAA Pilot Certificate?
 
                    0Yes                   0No   
 
See block N. for FAA Certificates. An FAA license issued on a foreign license IS an FAA Pilot Certificate
N. Grade of Pilot Certificate
FAA Licenses ONLY.
Student, Recreational,Private, Commercial or ATP.
DO NOT PUT NON-FAA LICENSE INFORMATION HERE
O. Certificate number
 
FAA Licenses   ONLY.
 
P. Date issued
12 / 25 /   2009
Month Day Year
Numbers ONLY.
Q. Do you hold a                                      
     Medical Certificate?   Must be an FAA medical for issue of a  stand alone FAA license.          0Yes                   0No
R. Class of Certificate
1st, 2nd or 3rd ONLY.
DO NOT write First, Second or Third regardless of what your medical says!
S. Date Issued
12 / 25 / 2009
Month Day Year
Numbers ONLY.
T. Name of Examiner
U. Have you ever been convicted for violation of any Federal or State statutes relating to narcotic drugs, marijuana or depressant or stimulant drugs or substances?
                                                                                           0Yes            0No
V. Date of Final    Conviction
II. Certificate or Rating Applied For on Basis of:
 0A. Completion of   Required Test
1.Aircraft to be used (If Flight test is required).
Only required if flight test is required.
2a. Total time in this aircraft/Sim/FTD
2b. Pilot in command
0 B. Military Competence
 obtained in
1.Service
2.Date rated
3.Rank or Grade and Service Number
4a.Flown 10 hours PIC in last 12 months in the following Military Aircraft.
4b.US Military PIC & Instrument check in last 12 months (List aircraft)
0 C. Graduate of Approved
Course
1.Name and location of Training Agency or Training Center
1a.Certification Numbet
2.Curriculum From Which Graduated
3.Date
0 D. Holder of Foreign License
Issued by
Tick only if the Non-FAA license plays any part of the issue of the new FAA license.
 
1.Country
 
Country that issued the non-FAA license
2.Grade of Licence
Indicate:
Private, Commercial or ATP ONLY.
*Do not write PPL, CPL or ATPL
Note: THERE IS NO SUCH THING AS A FROZEN ATP!!!!!
3.Number
This is the entire number including letters and symbols exactly as printed on your non-FAA license and must match exactly as indicated on the foreign license verification letter.
4.Ratings
Indicate foreign license ratings EXACTLY as indicated on the foreign license as clearly as possible..
 
 
III. RECORD OF FLIGHT TIME (Do not write in the shaded areas.)
1.       License validation and English Proficient Applicants need not indicate any hours in this section at all but if you do you must not indicate hours and minutes i.e; 75 hours and thirty minutes must be indicated as 75.5.
2.       Flight test applicants MUST indicate at least the MINIMUM hours required for the flight test applied for although it is recommended to list all hours.
3.       If this section is required the same criteria as note 1 applies.
NOTE: FLYING UNDER IFR DOES NOT MEAN YOU WERE IN IMC. INSTRUMENT TIME IN SECTION III IS THE ACTUAL TIME YOU HAVE LOGGED IN INSTRUMENT (IMC) CONDITIONS NOT IFR I.E, THE TIME YOU PERSONALLY CONTROLLED THE AIRCRAFT SOLEY BY REFERENCE TO INSTRUMENTS REGARDLESS OF WHETHER OR NOT YOU WERE ON AN INSTRUMENT FLIGHT PLAN!
IV. Have you ever failed a test for this certificate or rating?          0Yes                 0No
V. Applicant’s Certification – I certify that all statements and answers provided by me on this application form are complete and true to the best of my knowledge and I agree that they are to be considered as part of the basis for issuance of any FAA certificate to me. I have also read and understand the Privacy Act Statement that accompanies this form.
Signature of Applicant
Date
 
 
 
The Instructors section on page 4 must be filled out as follows: May be left blank for 61.75 license validations, English Proficient, Flight Instructor renewals/reinstatements or ATP flight tests.
                     Instructor’s Recommendation
 I have personally Instructed the applicant and consider this person ready to take the test.
Date
 
12 / 25 /   2009
Month Day Year
Numbers ONLY.
Instructor’s Signature   (Pint Name & Sign)
Instructor MUST print name & sign
Certificate No:
 
Complete certificate number:
 
         123456789CFI
Certificate Expires
12 / 25 /   2009
Month Day Year
Numbers ONLY.
Regardless of the date format on the CFI’s Instructor’s certificate!
 
It is acceptable for the 8710-1 application to be NEATLY hand written but we would prefer that it be typed.




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