(F I R S T N A M E ) (M I D D L E N A M E ) (L A S T N A M E ) City State PIN STD Code Landline Mobile. month

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1 GOVERNMENT FLYING TRAINING SCHOOL, JAKKUR BANGALORE APPLICATION FORM Entrance 2013 APPLYING FOR : CPL/PPL 1. Examination Centre : Government Flying Training School, Jakkur Bangalore. Paste recent 3 cm x 4cm Passport size photograph and sign 2. Candidate s Name 3. Sex: M / F Tick as applicable (F I R S T N A M E ) (M I D D L E N A M E ) (L A S T N A M E ) 4. id: 5. Father s Name: 6. Postal Address : City State PIN STD Code Landline Mobile 7. Category GEN / SC / ST / OBC : ( Tick as applicable and produce relevant certificates before Interview) 8. Date of Birth / / Note: Candidates must be 17year before joining the course (attach D D M M Y Y certificate) 8a. Age : year month 9. (a) Place of Birth: (b) District : (c) State: 10. Nationality*: 11. Any flying experience: (if you have any attach Certificate) 12. Qualifying Examination (10+2 or equivalent) ( attach all certificates) (i) Board Qualifying Examination 1 CBSE 2 CISCE 3 Any Indian State Education Board 4 Any other Equivalent Board/ University (i) a Please mention details of (4) (ii) 10+2 English (iii) 10+2 Maths (iv)10+2 Physics Not Eligible for course if, i. Not Passed English in 10+2 OR ii. Aggregate in 10+2 i.e. (% 10+2 Maths + % 10+2 Physics) Less Than 55% for Gen Candidates OR 50% for SC/ST/OBC candidates

2 (v) Additional Qualification, if any (with Maths & Physics as subject) Enter Qualification : : : 13. Demand Draft Details: In favor of Payable at Amount Demand Draft No. Dated Drawn on Bank Director, Govt. Flying Training School Bangalore Rs. 4000/- D.D. Amount paid is non-refundable 14. Type of Aircraft chosen for flying (Cessna-152A OR 172 ) 15. Declaration: I hereby declare that the particulars furnished above are true to the best of my knowledge and if above information is found to be incorrect at any stage, I understand that my candidature will stand cancelled. 16. Enclosures: a) Demand Draft for Rs. 4000/- (non-refundable) b) Two Self Attested Passport Size Photographs (One pasted on Application Form and the other enclosed with name overleaf) c) Date of Birth Certificate d) Qualification Certificate attested by Gazetted Officer NOTE: Candidate should download this form and fill up and submit to Director, Govt. Flying Training School with all documents and fees. * In case of a Foreign National he/she should get all permission from Government as envisaged in law. Date: / /2013 (SIGNATURE OF CANDIDATE) Mark obtained in written Exam: Recommendation of C.F.I.:

3 OFFICE OF THE DIRECTOR Government Flying Training School Jakkur Aerodrome, Bangalore (Government of Karnataka) PROCEDURE FOR SELECTION ( Second Batch of students shall be 15 for CPL and 05 for PPL) 1. WRITTEN EXAMINATION : Elementary English, Mathematics and Physics of 10 th Standard level. 2. INTERVIEW: General spoken language and aptitude for Aviation. 3. PILOT APTITUTE TEST: The pattern of examination will be explained before attempting this test. 4. WEIGHTAGE: a) Written Examination - 30% (Max. marks 100) b) Interview - 20% (Max. marks 20) c) Pilot Aptitude Test - 30% (Max. marks 50) d) 10/ 10+2 marks - 20% (Max. marks 100) 5. Final Admission is subjected to Medical Fitness. After class I/II medical. 6. Government Flying Training School will automatically transfer the unfilled vacancy to the next candidate in waiting list after a period of 15 days from the date of Admission if any students fails to appear on due date. 7. Students attendance is mandatory as per the flying and ground lecture schedule prepared by the school.

4 ADMISSION SCHEDULE BATCH -II 1 Submission of Application Form 08 th Jan Written Examination, Interview and Pilot Aptitude Test ( Venue: Government Flying Training School Jakkur Aerodrome, Bangalore onwards Same day/02 days after submission of application. 3 Result of Examination Next day of written exam 4 Medical Examination Class I /II As per Doctor s appointment 5 Admission After medical fitness 6 SPL Classes 14 days after submission of application 7 Flying Commences After SPL exam

5 CLASS I INITIAL MEDICAL EXAMINATION AIR FORCE MEDICAL CENTRES: Sl. No Address Contact Numbers & Id Time for communication 1 Air Force Central Medical Establishment (AFCME), Subroto Park, New Delhi Tele : , Fax : afcmedelhi@yahoo.co.in afcmedelhi@nic.in Monday Friday 1000hrs 1200hrs Mode of getting appointment / Post/ 2 Medical Evaluation Cell (East) 5 Air Force Hospital, Rowriah, Jorhat (Dist) Assam Tele : meceast@gmail.com Monday Saturday 0800hrs 1300hrs / Post/ 3 Medical Evaluation Centre (MEC), Institute of Aerospace Medicine (IAM), Indian Air Force, Vimanpura Post, Bangalore Tele : Extn- 3375/3339 Fax : meciamboard@gmail.com Monday Friday 1000hrs 1300hrs / Post/ CIVIL MEDICAL CENTRES : 4 Max Healthcare Institute Ltd., Max Med Centre, N-110, Panchsheel Park, New Delhi Tele : Fax : cpl@maxhealthcare.com h / Fax/Post/ 5 Dr. Balabhai Nanavati Hospital, S.V. Road, Ville-Parle (West) Mumbai Apollo Heart Centre, (Annexe of Apollo Hospitals) 156, Greams Road, Chennai Tele : /64/65 Fax : bnhopd@nanavatihospital.org Website : Tele : / Fax : pilotmedicals_cni@apollohospitals.com Website: h / Fax/Post/ h / Fax/Post/

6 CLASS II MEDICAL EXAMINATION : Sl. No Name Address of facility for Conduct of Examination Contact Details 1 Dr. Pankaj Tyagi SAMECS Civil Pilot s Medical Examination Facility Sannati Speciality Hospital #260, Amarjyothi Layout, Inner ring road, Domlur Extension, Bangalore Dr. US Mohalanobish # 966, 1 st Floor 12 th Main, HAL 2 nd Stage, Indiranagar, Bangalore Cell: Landline: Fax: pankaj.tyagi@samecs.net appointments@samecs.net Cell: Landline: bish@bish.in mohalanobish@gmail.com 3 Dr. Indranil Chakraborty Columbia Clinic, Bashettihalli, Doddaballapur, Bangalore Cell: Tele: Fax: drindranilavmed@yahoo.com