Appendix A APPENDIX A. APPLICATION INFORMATION Figure A-1. Sample Air Agency Certificate
UNITED STATES OF AMERICA
DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION Air Agency Certificate Number BXIS This certificate is issued to Sebago Lake Aviation whose business address is 15 Airport Drive, Portland, Maine 04897 upon finding that its onganization complies in all respects with the requirements of the Federal Aviation Regulations relating to the establishment of an Sin Agency, and is empowered to operate an approved Provisional Pilot School with the following ralings:
Private Pilot Course, Commercial Pilot Course, Instrument Rating Course This certificate, unless canceled, suspended, on revoked, shall continue in effect until October 31, 2019 By direction of the Administraton Date issued:
October 15, 2017 SAL BE MEDIATEL REPORTED TO THE AN OPRIATE REGIONAL DENICE OF THE FECAL SORTIN ADMINISTRATOR REOF., Any alteration of this certificate is punishable by a fine of not exceeding $1,000, or imprisonment not exceeding 3 years, or both FAA Form 8000-4 (1-67) SUPERSEDES FAA FORM 390. Electronic Forms (PDF) A-1
Appendix A Figure A-2. Sample Application for Pilot School Certification US Department of Transportation APPLICATION FOR PILOT SCHOOL CERTIFICATION Form approved: OME No. 2120-000 Federal Aviation 04/30/2019 Administration CERT For FAA Use Only APPLICANT - Read submittal and signature instructions on reverse. NO.
NAME OF SCHOOL TELEPHONE NO. ADDRESS OF PRINCIPAL BUSINESS OFFICE
LOCATION OF MAIN OPERATIONS BASE LOCATION OF SATELLITE BASE(S) APPLICATION IS HEREBY MADE FOR:
Issuance of a Pilot School Certificate and associated ratings to conduct the training courses identified below, and for the approval of these courses (three copies of each course outfine are affached); also, examining authority is requested for the courses appropriately checked.
Renewal of a Pilot School Certificate and associated ratings currently numbered , which expires on
• without changes to the currently approved course outlines. copies of each course outline is attached), including request for examining authority for the course(s) appropriately checked: with ation of or tre courses aprepatey chick aproval is requested frete with deletion of course(s) identified below from the curriculum.
Amending the current Pilot School Certificate and associated ratings numbered . wnien expires on
• by adding the course(s) identified below for which approval is requested (three copies of each course outline are attached), including request for examining authority where appropriately checked: - for deletion of the course(s) identified below from the curriculum.
DENTIFICATION OF TRAINING COURSES NOTE.. Where examining authority for a course is desired. piece and "X"in the (If more space is needed. continue on reverse in space provided) (WE) certify that I am (we are) familiar with Part 141 of the Federal Aviation Regulations, and, to the best of my (our) knowledge, believe that my (our) school meets tha equirements for certification s prescribed therei Signature and Title(s) Date
FOR FAA USE ONLY
• APPROVED- - a Provisional Pilot School Certificate - a Pilot School Certificate, either with • DISAPPROVED associated ratings bearing the number shown above is issued effective 40 96 532t9 01 Renewal without amendments • with amendments • Amendments
SIGNATURE OF APPROVING OFFICIAL TITLE DATE FAA Form 8420-8 (1-82) Recommendations of Inspector(s) on reverse A-2
Appendix A Figure A-2. Sample Application for Pilot School Certification (Continued) INSTRUCTIONS TO THE APPLICANT:
Submit an original and one copy of this application, completed in full, along with the required number of attachments where specified on the face of this form, to the FAA District Office having jurisdiction over the area in which the school is located.
Signatures on the application should be as follows:
a. Application from a person acting as an individual should be signed by the owner;
b. Application from a partnership should be signed by all partners;
c. Application from a corporation should be signed by the president or such other officers as authorized by the corporation by-laws to sign for the corporation and certified to by the corporate secretary attesting to the authority of the individuals to sign such a document;
d. Application from a company, club, or association should be signed by the president or such other officer o director as authorized by the organization's by-laws, and attested to by the secretary IDENTIFICATION OF TRAINING COURSES (Continued) NOTE: Where examining authority for a course is desired. place and "X" in the Dox adacent to me course
THE FOLLOWING SPACE FOR FAA USE ONLY Recommendations of Inspector(s)
INSPECTORS' FOR OPERATIONS FOR MAINTENANCE FOR AVIONICS
SIGNATURES DATE DATE DATE
AND DATES A-3
Appendix A A-4 Figure A-3. Sample Letter of Intent August 1, 2017 Mr. Robert Taylor Manager, Flight Standards District Office Federal Aviation Administration Portland International Jetport Portland, Maine 04897 Subject: Letter of Intent to Become a Provisional Pilot School under Title 14 of the Code of Federal Regulations Dear Mr. Taylor:
This is to notify the Portland, Maine, Flight Standards District Office (FSDO), Federal Aviation Administration (FAA), of our intent to become a Provisional Pilot School under Title 14 of the Code of Federal Regulations (14 CFR) part 141. We are prepared to begin operations on August 30, 2017.
We will be using electronic signatures and electronic copies of all documents, including submitting FAA Form 8420-8, Application for Pilot School Certification; training course outlines (TCO); and syllabi electronically.
We anticipate operations will be conducted from the General Aviation Terminal, Portland Airport. Our primary airport address is 15 Airport Drive, Portland International Airport, Portland, Maine 04897. My email address is travislee@pwn.com and this will be the primary email address for all electronic communication between myself and the Portland FSDO.
We intend to operate two Cessna 152s, one Cessna 182RF, one PA-32 Piper Seneca, and a Robinson R-22 helicopter. We propose to use the three-letter designator SLX, SLY, or SLZ (in order of preference) for our letters of authorization (LOA) and certificate management purposes. Ms. Nancy Build, holder of Flight Instructor Certificate number 543848384, is the chief instructor for all courses and meets the chief instructor requirements of part 141, § 141.35.
I have attached a copy of her pilot resume that may be verified when your inspection is conducted.
Attached to this email is a copy of each proposed TCO and syllabus for your review and approval.
Sincerely, Travis E. Lee Owner Sebago Lake Aviation Portland, Maine 04897
Appendix A A-5 Figure A-4. Sample Letter of Intent—Electronic Recordkeeping and Electronic Signature August 1, 2017 Mr. Robert Taylor Manager, Flight Standards District Office Federal Aviation Administration Portland International Jetport Portland, Maine 04897 Subject: Use of Electronic Systems—Signatures/Recordkeeping/Manuals Dear Mr. Taylor:
This letter is to inform you that Sebago Lake Aviation intends to use an electronic system for signatures, recordkeeping, training course outlines (TCO), syllabi, and other documents.
Apple iMacs will be used for documents, including recording of pilot records, and other correspondence, including TCOs and syllabi. These documents will be in a Microsoft Word format, Adobe PDFs, and other formats to record information. Electronic signatures will use Adobe PDFs for all electronic signatures. We will also provide Apple iPads for each student’s use to obtain weather briefings and store syllabi, electronic maps, and individual flying time.
This system has been established using the guidelines outlined in Federal Aviation Administration (FAA) Advisory Circular (AC) 120-78A, Electronic Signatures, Electronic Recordkeeping, and Electronic Manuals.
This organization intends to implement the system on August 30, 2017.
Company facilities, equipment, and personnel are available for your review and/or inspection at 15 Airport Road, Portland, Maine 04897 on August 15, 2017. Please contact Travis E. Lee, at 207-555-6310, to arrange a visit to review the system and to discuss any FAA concerns.
Thank you in advance for your assistance in this matter.
Sincerely, Travis E. Lee Owner Sebago Lake Aviation Portland, Maine 04897
Appendix B B-1 APPENDIX B. SAMPLE TRAINING COURSE OUTLINE AND SYLLABUS Figure B-1. Sample Training Course Outline This sample private pilot training course outline (TCO) is intended to serve as a general guide for the preparation of a TCO for which FAA approval is sought. Schools may develop their own training syllabus or use a commercially prepared syllabus. If a commercially prepared syllabus is used, it must meet the needs of the particular school (e.g., physical layout of the operation, personnel, aircraft, kinds of training aids available, methods and procedures of operation, and the goals and standards of the school).
The content of the training syllabus contained herein is not considered to be the optimum.
A syllabus should be developed that best suits the school, where training procedures are often dictated by weather, location, or specific training needs. This sample contains a training syllabus for both private pilot ground and flight training and is designed to be taught concurrently.
Note: Pilot school students trained under 14 CFR part 141 must be tested under 14 CFR part 61. However, part 61, § 61.71 provides for graduates from FAA-approved part 141 training programs.
Sample: Sebago Lake Aviation TCO
1. Flight School. Sebago Lake Aviation located at the Portland, Maine Airport; holds Air Agency Certificate No. BX7S; and is owned and operated as:
Sebago Lake Aviation 15 Airport Road Portland, ME 04897
2. Course Title. Private Pilot Certification Course Airplane Single-Engine Land (ASEL).
a. This TCO meets the curriculum requirements for the Private Pilot Certification Course contained in part 141 appendix B.
b. The training syllabus provided contains separate ground and flight training courses, which will be taught concurrently.
3. Course Objective. The student will obtain the knowledge, skill, and aeronautical experience necessary to meet the requirements for a private pilot certificate with an airplane category rating and a single-engine land class rating.
4. Completion Standards. The student must demonstrate through written tests, practical tests, and appropriate records that he or she meets the knowledge, skill, and experience requirements necessary to obtain a private pilot certificate with an airplane category rating and a single-engine land class rating. Each individual must satisfactorily complete at least one stage of training within each training period of not more than 90 days.
Appendix B B-2
5. Ground Instructional Facilities. Ground instructional facilities are located in Hangar No. 12 at the Portland Airport. They consist of two 50-feet x 50-feet rooms, equipped with tables, chairs, and instruction booths.
a. Training Room No. 1 is equipped with 8 tables and chairs to accommodate 16 students.
The room is also equipped with a large white board, an Apple 27-inch iMac (late 2015 model) computer, and a projector and screen. The tables are equipped with a “four-answer” responder system, with the master panel located on the instructor’s lectern.
b. Training Room No. 2 is equipped with nine individual training booths. Eight booths are equipped with Apex Visual Screens and projectors. One booth is equipped with closed-circuit television.
c. The training rooms are well lighted and the temperature is thermostatically controlled.
Each room is well ventilated and conforms to the city of Portland building, sanitation and health codes. The rooms are designed and located so that students will not be distracted by instruction conducted in the other rooms or by flight and maintenance operations at the airport.
6. Airport. The Portland Airport is the main base of operations for training in this course and where training flights originate. Flight training operations, including the dispatching of flights, will be at this airport and also at the Sanford, ME airport. The Portland and Sanford airports have hard-surfaced runways and meet § 141.38 requirements for day and night flight operations. Both airports have fuel and maintenance services available.
7. Airport Facilities. Each airport is equipped with a pilot briefing room for Sebago Lake Aviation students. Both briefing areas have a computer with Internet access for weather briefings, a telephone, cell phone, and Internet connections dedicated to contacting Flight Standards Service (AFS) facilities used exclusively by Sebago Lake Aviation students. Both briefing rooms are equipped with numerous tables for planning purposes. Both briefing areas have a full set of current aeronautical charts, including the current Aeronautical Information Manual (AIM). Large wall maps with a mileage indicator depict the entire United States.
The local practice areas are displayed along with the Portland Tower frequencies and Sanford Unicom frequencies.
8. Ground Trainers. [NAME of PILOT SCHOOL] has two [NAME OF MANUFACTURER & MODEL] [TYPE examples: Aviation Training Device (ATD), flight training device (FTD), or full flight simulator (FFS)] that will be used to provide training as described in the approved training course syllabus. The specific lessons will be identified when using the ATD for pilot training. Each trainer is FAA approved and is accompanied by a valid letter of authorization (LOA) and Qualification and Approval Guide (QAG). These training devices meet the requirements as described in § 141.41.
9. Airplanes. Airplanes used for all flight training in this course include one Cessna 150 Aerobat, three Cessna 152s, two Cessna 172s, and a Piper Arrow. These aircraft will meet the requirements of § 141.39. The Cessna 172s all are factory glass panels with Automatic
Appendix B B-3 Dependent Surveillance—Broadcast (ADS-B) IN and OUT, which interface with an iPad.
The Piper Arrow has a multifunction display (MFD) with Global Positioning System (GPS) navigation, a horizontal situation indicator (HSI), one very high frequency omni-directional range (VOR) navigational receiver, and a 4096 code transponder with Mode C capability. Each airplane is equipped for day and night visual flight rules (VFR) and instrument flight rules (IFR) flying, as specified in 14 CFR part 91, § 91.205.
10. Chief Instructor. The chief instructor for training must be designated by name in the appropriate TCO. If the school’s requirements for a chief instructor are higher than those listed in § 141.35, those requirements should be listed.
11. Assistant Chief Instructor(s). The assistant chief instructor(s), if designated for a course of training, are listed by name in the appropriate TCO assigned duties at a satellite base. Those duties and the specific bases are listed by name.
12. Flight Instructors. The minimum qualifications and ratings for flight instructors are listed in the TCO. For example: Each flight instructor assigned to this course must be the holder of at least a commercial pilot certificate with an airplane category rating and a single-engine land class rating. The instructor must be the holder of a flight instructor certificate with an airplane category rating with a single-engine class rating and an instrument airplane rating. The instructor must also have a total of 1,000 hours of flying time, including at least 200 hours of flight instruction.
13. Chief Instructor for a Ground School Course. A chief instructor may be designated by name in the TCO for a ground school course of training, provided that person meets the requirements of § 141.35(e).
Appendix B B-4 Figure B-2. Sample Syllabus Private Pilot Course ASEL Ground Training [37 Hours]
1. Ground Training Course Objectives. The student will obtain the necessary aeronautical knowledge and meet the prerequisites specified in part 61 for a private pilot written test.
2. Ground Training Course Completion Standards. The student will demonstrate through practical tests, written tests, and records that he or she meets the prerequisites specified in part 61, and has the knowledge necessary to pass the private pilot written test.
3. Prerequisites for Enrollment. The minimum medical certification for this course is an FAA third-class medical. Upon enrollment in this course, the student must apply for a student pilot certificate.
Stage One: FAA Regulations and Other Publications [7 Hours]
1. Stage One Objective. To develop the student’s knowledge and understanding of the Federal aviation regulations, the AIM, the AC system, National Transportation Safety Board (NTSB) Title 49 of the Federal Code of Regulations (49 CFR) part 830, Chart Supplements, and the kind of flight operations facilitated by the private pilot certificate.
2. Completion Standards. This Stage One will be complete when the student successfully passes the Stage One final written examination with a grade of 80 percent.
Lesson 1 [2:00 Hours] Title: Regulatory Review Part 61 Objective: The student will be introduced to the appropriate content of 14 CFR part 1 and the regulatory requirements of parts 61 and 91.
Content:
a) Airplane registration and airworthiness certificate.
b) Part 1, Definitions and Abbreviations, appropriate to the private pilot.
c) Part 61 review.
d) Requirements for certificates and ratings, privileges, and limitations.
e) Duration of pilot certificates.
f) Medical certificate requirements, classes, and duration.
g) Written tests.
h) Practical tests.
Appendix B B-5
i) Pilot logbooks and flight records, logging of pilot time.
j) Recency of experience requirements, including flight review,
k) Private pilot privileges and limitations.
Completion Standards: The student will have successfully completed the lesson when, by oral examination, the student displays a working knowledge of the appropriate portions of parts 1, 61, and 91 and demonstrates how to locate and use information in the rule.
Lesson 2 [2:00 Hours] Title: Regulatory Review Part 91 and NTSB Objective: Lesson No. 1 will be reviewed. The student will be instructed in the pertinent regulatory requirements of part 91 and the accident report rules of the NTSB (49 CFR part 830) as related to private pilot operations.
Content:
a) Part 91.
b) General operation rules.
c) VFR requirements.
d) IFR requirements.
e) Maintenance, preventative maintenance, and alteration.
f) Aircraft registration and airworthiness.
g) Transponder and encoder requirements.
h) Traffic patterns (towered and nontowered airports).
i) Temporary flight restrictions (TFR).
j) Restricted and prohibited airspace.
k) NTSB 49 CFR part 830 notification and reporting of accidents.
Completion Standards: The lesson will be successfully completed when, by oral examination, the student can demonstrate how to locate and use information in the part 91 rule as related to private pilot operations, and demonstrates an understanding of 49 CFR part 830.
Appendix B B-6 Lesson 3 [2:30 Hours] Title: AIM and ACs Objective: The student will be given instruction in the basic content of the AIM for VFR operations, the AC system, and the Airport Facility Directory (AFD).
Content:
(1) AIM.
(a) Air navigation radio aids.
(b) Airport air navigation lighting and runway and taxiway marking.
(c) Airspace Classes A through G.
(d) Restricted areas, TFRs.
(e) Prohibited areas, warning areas, and Military Operations Areas (MOA).
(f) Air traffic control (ATC).
(g) Services available to pilots.
(h) Airport operations, to include high-density airport operations.
(i) Emergency procedures.
(j) Good operating practices, to include collision avoidance.
(2) The AFD.
(3) FAA AC 00-, 60-, 90-, and 120-series (familiarization).
Completion Standards: The student will have successfully completed the lesson when, by oral examination and demonstration, he or she displays basic knowledge of the appropriate parts of the AIM for VFR operations, the AFD, and the AC system.
Appendix B B-7 Lesson 4 [00:30 Hour] Title: Stage One Final Exam Content: Knowledge Examination (Written Exam) Completion Standards: The student will have successfully completed Stage One when, by written examination, he or she demonstrates significant knowledge and understanding of the appropriate parts of parts 61 and 91, NTSB rules, the AIM for VFR operations, the AFD, and the AC system, with a pass rate of at least 80 percent, corrected to 100 percent after review of the exam results.
(A copy of the Stage One final knowledge examination should be included with the training syllabus when submitted to the FAA FSDO for review. The examination should be comprehensive and contain questions on information covered during this stage.)
Note: This is just a portion of a sample syllabus. The school can develop its own, or purchase a commercially developed syllabus for submission to the jurisdictional FSDO for review.