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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. Email 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

(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.:

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.

ADMISSION SCHEDULE BATCH -II 1 Submission of Application Form 08 th Jan 2014 2 Written Examination, Interview and Pilot Aptitude Test ( Venue: Government Flying Training School Jakkur Aerodrome, Bangalore-560064 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

CLASS I INITIAL MEDICAL EXAMINATION AIR FORCE MEDICAL CENTRES: Sl. No Address Contact Numbers & Email Id Time for communication 1 Air Force Central Medical Establishment (AFCME), Subroto Park, New Delhi 110 010 Tele : 011-25682153, 25690456 Fax : 011-25693831 Email : afcmedelhi@yahoo.co.in afcmedelhi@nic.in Monday Friday 1000hrs 1200hrs Mode of getting appointment Email / Post/ 2 Medical Evaluation Cell (East) 5 Air Force Hospital, Rowriah, Jorhat (Dist) 788 005 Assam Tele : 0376-2333081-82 Email : meceast@gmail.com Monday Saturday 0800hrs 1300hrs Email / Post/ 3 Medical Evaluation Centre (MEC), Institute of Aerospace Medicine (IAM), Indian Air Force, Vimanpura Post, Bangalore 560 017 Tele : 080-25224131 Extn- 3375/3339 Fax : 080-25224659 Email : meciamboard@gmail.com Monday Friday 1000hrs 1300hrs Email / Post/ CIVIL MEDICAL CENTRES : 4 Max Healthcare Institute Ltd., Max Med Centre, N-110, Panchsheel Park, New Delhi 110 017 Tele : 011-26499870 Fax : 011-26499860 Email : cpl@maxhealthcare.com 0800 1700h Email / Fax/Post/ 5 Dr. Balabhai Nanavati Hospital, S.V. Road, Ville-Parle (West) Mumbai 400 056 6 Apollo Heart Centre, (Annexe of Apollo Hospitals) 156, Greams Road, Chennai 600 006 Tele : 022-26182263/64/65 Fax : 022-26172286 Email : bnhopd@nanavatihospital.org Website : www.nanavatihospital.org Tele : 044-28296900/28296901 Fax : 044-28294455 Email : pilotmedicals_cni@apollohospitals.com Website: www.apollohospitals.com/dgca 0800 1700h Email / Fax/Post/ 0800 1700h Email / Fax/Post/

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 560 071 2 Dr. US Mohalanobish # 966, 1 st Floor 12 th Main, HAL 2 nd Stage, Indiranagar, Bangalore 560 094 Cell: 9980668250 Landline: 080-41123833 Fax: 080-41492211 Email: pankaj.tyagi@samecs.net appointments@samecs.net www.samecs.net Cell: 9845171863 Landline: 080-41154599 Email: bish@bish.in mohalanobish@gmail.com 3 Dr. Indranil Chakraborty Columbia Clinic, Bashettihalli, Doddaballapur, Bangalore 561 203 Cell: 9620823378 Tele: 08119-300300 Fax: 08119-300301 Email: drindranilavmed@yahoo.com