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.

View the file

Other files

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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.

� EMBED WangImage.Document ���

_1295090822.bin

File details come from the government source that posted it. Updated .