Electronic Pilot Approval Form.doc
DOC document 141 KB Posted
- Attached to
- FFP Eastern Attack Helo
- Solicitation number
- 6100066023
- Issued by
- Carbon County, Pennsylvania
About this file
This file is an Electronic Pilot Approval Form document used by the Pennsylvania Department of Conservation & Natural Resources, Bureau of Forestry, to evaluate and certify pilot qualifications for wildfire suppression operations. The form captures comprehensive pilot information including personal details, emergency contact information, employer data, airman certification credentials (ATP, commercial, and rotorcraft ratings), medical certification status, and detailed flight hour requirements across multiple categories such as multi-engine, cross-country, night, instrument, and terrain-specific flying experience. The form also requests information regarding prior approvals from interagency carding, related training attended within the past five years, and any history of approval denials, suspensions, or revocations. Applicants must certify the accuracy of all statements provided, and the form requires attestation by an authorized employer representative to be deemed valid. The document is dated January 2009 and serves as a critical screening instrument for pilots seeking authorization to operate rotary-wing aircraft in Pennsylvania's wildfire response program.
The approval form does not directly address pricing, contract terms, or funding sources; however, it functions as a prerequisite qualification document for the FFP Eastern Attack Helo contract opportunity, which requires one properly certificated and inspected rotary-wing aircraft equipped with firefighting capabilities and qualified pilots for aerial water delivery and wildfire suppression support. The form's emphasis on detailed flight experience verification, current medical certification, and employer attestation reflects the high operational standards and safety requirements necessary for contractors engaged in aerial firefighting services for the Pennsylvania Department of Conservation & Natural Resources.
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Other files
| File | Type | Posted |
|---|---|---|
| Terms and Conditions.pdf | ||
| Addendum 1 - 6100066023 - 8-5-2026.pdf | ||
| Electronic Aircraft Description Form.doc | DOC document | |
| Worker Protection Form-BOP-2201 .docx | DOCX document | |
| DCNR Small Business Procurement Initiative.pdf | ||
| Eastern Attack Helicopter SOW.pdf |
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Text version
1. Name of Pilot (Last, First, MI) PA Dept. of Conservation & Natural Resources
| 2. Mailing Address |
| Bureau of Forestry |
| 3. City, State, Zip |
| Pilot Approval Form |
| 4. Home Phone |
| 5. Age |
| 6. Marital Status |
7. In the Event of an Emergency Notify:
| A. Name |
| B. Street Address, City, State |
| C. Phone |
| D. Relationship |
8. Employer Information
| A. Name of Employer |
| B. Employment Terms (Fulltime, Year Long, Seasonal, etc.) |
9. Airman Certification Information
| A. Type |
| B. Check All Appropriate |
| C. Certificate Number |
| ATP |
| FORMCHECKBOX |
| COM |
| FORMCHECKBOX |
| ASEL |
| FORMCHECKBOX |
| AMEL |
| FORMCHECKBOX |
| ASES |
| FORMCHECKBOX |
| AMES |
| FORMCHECKBOX |
| Rotor |
| FORMCHECKBOX |
| D. Instrument Rating |
| E. Ratings (include Type Ratings if applicable) |
| F. Last BFR Date |
| yes |
| FORMCHECKBOX |
| no |
| FORMCHECKBOX |
| G. Last Instrument Comp Check |
| H. Medical Class |
| I. Issue Date |
| J. Limitations to Airman Certificate or Medical |
| 10. Flight Hour Information |
| 11. Air Tanker Flight Hour Information |
| . |
| Total |
| Multi Engine |
| Past 12 Months |
| A. Pilot |
| Hrs |
| Hrs |
| Hrs |
| Approval Applied for |
| Total Hours |
| Hours Last 30 Days |
| Type: |
| B. Cross Country |
| Hrs |
| Hrs |
| Hrs |
| Type: |
| C. Night |
| Hrs |
| Hrs |
| Hrs |
| Type: |
| D. Instrument & Hood |
| Hrs |
| Hrs |
| Hrs |
| Type: |
| E. In Type to be Flown |
| Hrs |
| Hrs |
| Hrs |
| Type: |
F. Typical PA Terrain Flying Total Hours:
| 12. Last Approvals Issues (Interagency Carding, etc.) |
| G. Experience from Designated Base, Number of Seasons: |
| Attach/Scan a Copy of Interagency Card To/With This Form. |
13. Related Schools Attended Last 5 Years (Forest Service or Other)
14. Any Previous Approval Denied, Suspended, or Revoked? If Yes, Explain:
Certify that the Statements Made Hereon are True.
| 15. Signature of Applicant: |
| Date: |
| Attested to by Employer (Signature Required) |
| Date |
1 Jan 2009 Edition
BoF Pilot Approval Form 09
THIS FORM MUST BE SIGNED BY A REPRESNTATIVE OF THE EMPLOYER TO BE ACCEPTED.
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File details come from the government source that posted it. Updated .