Details Participants
| |
| |
| |
| |
n TRI n SFI n MCCI
n MPL n No restrictions n FFS only n A n H
Details assessment of competence
n Inital issue n Revalidation n Renewal
| |
| |
|
Start time:|
Finish time:Evaluation of applicant
+ - n/a
|
A. Applicant requirements|
1. Applicant/instructor meets part-FCL requirements □ n n|
2. Applicant/instructor theoretical knowledge □ n n This form shall be used by a qualified examiner to report the result ofan instructor assessment of competence (AoC).
Designation of an examiner for the assessment of competence for the first issue of a flight- instructor (FI) certificate may only be arranged by the CAA-NL. All others may be arranged by either the CAA-NL or an Approved Training Organisation.
Incomplete or incorrectly filled out forms (including absence of additional documents) will not be processed.
Send a copy of the completed form to: Kiwa Register, Postbus 4, 2280 AA Rijswijk, The Netherlands or to e-mailaddress:
vergunningen@kiwa.nl
Additional information 088 489 00 00 | www.ilent.nl
1
1.1 Name / licence number applicant 1.2 Name / licence number examiner 1.3 Names / licence numbers flight
crew members
1.4 Holder of / applicant for 1.5 Remarks / restrictions 1.6 Category
2
2.1 Assessment of competence 2.2 Date and location of AoC 2.3 Aircraft type and registration
or Simulator type and FSTD number
2.4 Block time
3
3.1 Assessment
for TRI/SFI/MCCI
|
B. Briefing|
1. Lesson preparation □ □ □ n n n|
2. Presentation and discussion of subjects □ n n n□ □|
3. Structuring and time planning □ □ □ n n n|
4. Checking of theoretical knowledge □ □ □ n n n|
5. Interaction with trainee(s) □ □ □ n n n|
C. Session|
1. Flight/session preparation □ □ □ n n n|
2. Safety aspects □ □ □ n n n|
3. Structuring and time planning □ □ □ n n n|
4. Handling of simulator/aircraft □ □ □ n n n|
5. Handling of simulator/aircraft problems □ □ □ n n n|
6. Performing demonstrations □ □ □ n n n|
7. ME exercises □ □ □ n n n|
8. Simulating role as ATC, purser etc. □ □ □ n n n|
9. Interaction with trainee(s) □ □ □ n n n|
D. Debriefing|
1. Presentation and discussion of observations □ □ □ n n n|
2. Structuring and time planning □ □ □ n n n|
3. Interaction with trainee(s) □ □ n n n|
4. Trainee assessment/grading □ □ □ n n n|
E. Administration|
1. Aircraft/simulator/pilot documents and administration □ □ □ n n n|
2. Training reports/assessment □ □ □ n n n|
F. General|
1. Appearance/behavior □ □ □ n n n|
2. Exemplary role as instructor □ □ □ n n n|
3. Attitude □ □ □ n n n|
4. Quality of training □ □ □ n n n|
5. Integration of TEM/CRM/HF □ □ □ n n nResults
n A n B n C n D n E n F
4
Remarks
Signing applicant
>
Undersigned applicant is aware of the consequences of providing incomplete, inaccurate or false information related to the issue, revalidation or renewal of this licence or rating or certificate as specified in ARA.FCL.250(a) and ARA.GEN.355 or applicable national legislation.|
| |
|
Signing examiner
>
Undersigned examiner certifies that all requirements regarding the issue, revalidation or renewal of this licence or rating or certificate have been fulfilled in accordance with Part-FCL (FCL.1030(a)(2) and FCL.1030(b)(2)) or applicable national legislation.>
Undersigned non-Dutch examiner(s) declares that he/she has reviewed and applied the relevant national procedures and requirements of the CAA-Netherlands (ILT) contained in the below specified version of the EASA Examiner Differences Document.|
| |
| |
| |
| |
|
|
5
5.1 Your remarks
6
6.1 Name applicant 6.2 Date and place
6.3 Signature
7
7.1 Version E.D.D. (only for non-Dutch examiners)
7.2 Name(s) examiner(s) and certificate number(s)
7.3 Date and place
7.4 Signature(s)
8 Reference items
A1 Applicant/instructor meets Part FCL requirements A1.1 Identification of applicant/examiner
A1.2 Part FCL subpart J requirements A1.3 Instructor training completed
A2 Applicant/instructor theoretical knowledge A2.1 Applicable theoretical knowledge of applicant A2.2 Air law □
A2.3 Aircraft general knowledge □ A2.4 Flight performance and planning □ A2.5 Human performance and limitations A2.6 Meteorology □
A2.7 Navigation □
A2.8 Operational procedures □ A2.9 Principles of flight □ A2.10 Training administration □ B1 Lesson preparation
B1.1 Preparation of lesson resources B1.2 Preparation/knowledge of lesson goals B1.3 Preparation/knowledge of lesson elements B2 Presentation and discussion of subjects B2.1 Visual presentation □
B2.2 Technical accuracy □ B2.3 Clarity of explanation □ B2.4 Clarity of speech □ B2.5 Use of models and aids □ B3 Structuring and time planning B3.1 Structuring the briefing B3.2 Efficient use of briefing time B4 Checking of theoretical knowledge B4.1 Asks questions to check knowledge B4.2 Corrects incomplete/incorrect knowledge B5 Interaction with trainees
B5.1 Interactive discussion of subjects B5.2 Instructional technique □ B5.3 Trainee participation □
B5.4 Has good insight in trainees needs/expectations C1 Flight / session preparation
C1.1 Sticking to planned session/flight time schedule C1.2 Flight preparation
C2 Safety aspects
C2.1 Has knowledge of applicable safety aspects C2.2 Checks/explains safety aspects
C2.3 General airmanship and safety □ C2.4 Positioning and use of airspace □ C3 Structuring and time planning C3.1 Structuring the flight / session C3.2 Efficient use of flight / session time C4 Handling of simulator / aircraft C4.1 Aircraft/simulator handling □
C4.2 Using available features to maximize training C5 Handling of simulator/aircraft problems
C8 Simulating role as ATC, Purser etc.
C8.1 Using correct RT C8.2 Acting conform reality C9 Interaction with trainee(s)
C9.1 Interaction with trainee(s) during exercises C9.2 Observing trainee(s) performance and progress C9.3 Adapting the training to observed performance C9.4 Correction of faults □
C9.5 Instructional technique □
D1 Presentation and discussion of observations D1.1 Visual presentation □
D1.2 Technical accuracy □ D1.3 Clarity of explanation □ D1.4 Clarity of speech □ D1.5 Use of models and aids □ D1.6 Flexibility in debriefing skills
D1.7 Giving advice about studying / preparation D2 Structuring and time planning
D2.1 Structuring the debriefing D2.2 Efficient use of debriefing time D3 Interaction with trainee(s)
D3.1 Dealing with trainee(s) questions and opinions D3.2 Instructional technique □
D3.3 Trainee participation □
D3.4 Observant of trainee(s) emotions/state of mind D4 Trainee(s) assessment/grading
D4.1 Assessment of trainee(s) performance
D4.2 Determining to which extent goals were reached D4.3 Determining goals next training
E1 Aircraft/simulator/pilot documents and administration E1.1 Handling and registration of complaints
E1.2 Time / flight registration E1.3 Pilot logbooks
E2 Training reports / assessment E2.1 Trainee file
E2.2 Report according debriefing F1 Appearance / behavior F1.1 Use of correct language F1.2 Dresses appropriate F1.3 Behavior towards trainee(s) F1.4 Behavior towards others F2 Exemplary role as instructor F2.1 Acts in a professional manner F2.2 Acts as an example for trainees F3 Attitude
F3.1 Attitude to trainee(s)
F3.2 Attitude to regulations/authorities F4 Quality of training
F4.1 Creates atmosphere conductive to learning F4.2 Quality of theoretical training
F4.3 Quality of practical training
F4.4 Strives to improve training were possible F5 Integration of TEM/CRM/HF
F5.1 Knowledge of TEM/CRM/HF
Examples leading to a “-” : 1. Applicant does not meet requirements
2. Unable to give structured (de)briefing / handle subjects.
3. Not familiar with relevant legislation articles, documents and procedures 4. Not capable of (or unfamiliar with) operating simulator.
5. Not (capable of) assessing trainee performance or progress 6. Not showing desired attitude towards trainee and/or regulations.
7. Insufficient quality of theoretical and/or practical training.
8 Actions which negatively influence safety of the flight/session
