Flight Notification of Test

Name of examiner

Surname of examiner

Examiner certificate number

State of licence issue

E-mail address

Phone number

Name of candidate

Surname of candidate

Licence number CAA-SI

Type of test

Purpose of test

Type of aircraft

A/C or FSTD registration

Organization (ATO/DTO/AOC), if applicable

Planned location of test (ADR ICAO designator or site)

Planned date

Planned time

Comment