The questionnaire below helps me get some background on you and your flight training needs. Complete it and send it back to me after I receive this we can set up a time to speak by phone in more detail about your goals and schedule availability for flight training.
Sincerely,
Sky
Sky Smith, CFII New Instrument Student Questionnaire
Date:
STUDENT
Name:
Class of medical held:
Date of medical issuance:
Home base airport:
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AIRCRAFT
Type of aircraft presently being flown (year/make/model):
Tail number:
Date of last annual:
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AERONAUTICAL EXPERIENCE
Total flight hours:
In last 90 days:
————-
Total cross country PIC hours:
————-
Total instrument hours:
In last 90 days:
————-
IMC flight hours:
In last 90 days:
—————
Night Hours:
In last 90 days:
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AVIONICS:
Do you fly with a Garmin or Avidyne avionics system?
IF so, which one?
Is it WAAS?
Approximately many hours do you have using it?
Do you have an autopilot?
If so, which one?
Are you proficient with opperating your autopilot?
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WRITTEN EXAM:
score:
Codes of incorrect test answers:
—————
SUBJECT MATTER FAMILIARITY
Rate on a scale of 1 to 7 your proficiency/experience in the items listed below:
1=I don’t know what this is
2=I have some book knowledge on the topic
3=I have a lot of book knowledge on the topic
4=I have flown this 1-3 times before
5=I have flown this to ACS standard more than once
6=I feel confident that I can fly this on my own without instruction and consistently to ACS standards.
7=I’m confident I have this skill checkride ready and consistently above the ACS standards.
1. Hold entries
2. Flying Timed VOR Holds
3. Flying VOR DME Holds
4. Flying GPS Holds
5. Setting up an ATC assigned unpublished hold
6. CRAFT V calls
7. VOR approaches
8. NDB/ADF (if you have it on your aircraft)
9. Autopilot Operation (if you have it on your aircraft)
10. Localizer approaches with timing required
11. Localizer approaches with DME
12. LDA approaches
13. ILS approaches
14. Localizer back course approaches
15. GPS approaches
16. DME arcs
17. Steep turns under foggles
18. Unusual attitudes recoveries
19. Briefing approach plates (have you been show any process for annotating then before flying?)
20. Do you know your power settings for airspeed and decent rates for 500, 750 and 1000 feet per minute at 90knots?
ADDITIONAL INFO
Schedule Availability
Contact email
Contact phone number
Include PDF or JPEG image of Instrument panel and avionics set up.
Include a PDF attachment of your aircraft POH/AFM.
Include a PDF or JPEG of written test result sheet.
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