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GACA ال necesita للطيران المدني General Authority of Civil Aviation [Non-Text] ASSISTANT CHIEF INSTRUCTORS ACCEPTANCE APPLICATION FORM GACAR PART-141 A. FOR APPLICANT USE ONLY <table><tr><td colspan="4">1. 1. Pilot School/Organization information</td></tr><tr><td>a</td><td>Pilot School/Organization Name</td><td colspan="2"></td></tr><tr><td>b</td><td>Address</td><td colspan="2"></td></tr><tr><td>c</td><td>Contact Number</td><td colspan="2"></td></tr><tr><td>d</td><td>Email Address</td><td colspan="2"></td></tr><tr><td colspan="4">2. Applicant (Nominated Assistant Chief Instructors) information</td></tr><tr><td>a.</td><td>Name</td><td colspan="2"></td></tr><tr><td>b.</td><td>ID/Passport Number</td><td colspan="2"></td></tr><tr><td>c.</td><td>License Type</td><td colspan="2"></td></tr><tr><td>d.</td><td>License Number</td><td colspan="2"></td></tr><tr><td>e.</td><td>State Pilot License issuance</td><td colspan="2"></td></tr><tr><td>f.</td><td>Medical Class</td><td colspan="2"></td></tr><tr><td>g</td><td>Contact Number</td><td colspan="2"></td></tr><tr><td>h</td><td>Email Address</td><td colspan="2"></td></tr><tr><td colspan="4">3. Applicant (Nominated Assistant Chief Instructors) Qualifications</td></tr><tr><td colspan="4">Qualifications Relevant to Position (e.g. License (s), type/class ratings, instructor rating(s), Diploma, etc.)</td></tr><tr><td>a</td><td colspan="3"></td></tr><tr><td>b</td><td colspan="3"></td></tr><tr><td>c</td><td colspan="3"></td></tr><tr><td>d</td><td colspan="3"></td></tr><tr><td>e</td><td colspan="3"></td></tr><tr><td colspan="4">4. Applicant (Nominated Assistant Chief Instructors) Experience</td></tr><tr><td colspan="4">Work Experience Relevant to Assistant Chief Instructors Position</td></tr><tr><td>a</td><td colspan="3"></td></tr><tr><td>b</td><td colspan="3"></td></tr><tr><td>c</td><td colspan="3"></td><td</tr><tr><td>d</td><td colspan="3"></td></tr><tr><td colspan="4">5. Pilot School/Organization Declaration.</td></tr><tr><td>a</td><td colspan="3">Declaration By Nominated Assistant Chief Instructors</td></tr><tr><td colspan="4">I hereby declare that the information given in this form is true, correct and completed.</td></tr><tr><td colspan="2">Name</td><td>Signature</td><td>Date</td></tr><tr><td colspan="2"></td><td></td><td></td></tr><tr><td colspan="4"></td></tr><tr><td>b</td><td colspan="3">Certification By Accountable Manager</td></tr><tr><td colspan="4">I hereby declare that the applicant is nominated for Assistant Chief Instructors Position</td></tr><tr><td colspan="2">Name</td><td>Signature</td><td>Date</td></tr><tr><td colspan="2"></td><td></td><td></td></tr></table> GACA-AVSES-OPS-F023 Rev: 3, Date: 22 Jun 25 Page 1 of 3 GACA الهييه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] ASSISTANT CHIEF INSTRUCTORS ACCEPTANCE APPLICATION FORM GACAR PART-141 <table><tr><td colspan="4">B. ASSISTANT CHIEF INSTRUCTORS REQUIREMENTS</td></tr><tr><td colspan="3">GACAR PART-141.57 Assistant Chief Instructor Qualifications</td><td>YES NO</td></tr><tr><td>(a)</td><td>To be eligible for designation as an assistant chief instructor for a course of training, a person must meet the following requirements:</td><td>□</td><td>□</td></tr><tr><td>(1)</td><td>Hold a commercial pilot or an ATP certificate and, except for the assistant chief instructor for a course of training solely for a lighter-than-air rating, a current flight instructor certificate, each issued under GACAR Part 61. The certificates must contain the appropriate aircraft category, class, and instrument ratings if an instrument rating is required by the course of training for the category and class of aircraft used in the course.</td><td>□</td><td>□</td></tr><tr><td>(2)</td><td>Meet the PIC recent flight experience requirements of GACAR § 61.17(a).</td><td>□</td><td>□</td></tr><tr><td>(3)</td><td>Pass a knowledge test on—</td><td>□</td><td>□</td></tr><tr><td>(i)</td><td>Teaching methods;</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>Applicable provisions of the KSA AIP;</td><td>□</td><td>□</td></tr><tr><td>(iii)</td><td>Applicable provisions of GACAR Parts 61, 91, and 141; and</td><td>□</td><td>□</td></tr><tr><td>(iv)</td><td>The objectives and approved completion standards of the course for which the person seeks to obtain designation as an assistant chief instructor.</td><td>□</td><td>□</td></tr><tr><td>(4)</td><td>Pass a proficiency test on the flight procedures and maneuvers appropriate to that course.</td><td>□</td><td>□</td></tr><tr><td>(5)</td><td>Meet the applicable requirements in paragraphs (b), (c), and (d) of this section. However, an assistant chief instructor for a course of training for gliders, balloons, or airships is required to have only 40 percent of the hours required in paragraphs (b) and (d) of this section.</td><td>□</td><td>□</td></tr><tr><td>(6)</td><td>If the pilot school has or seeks examining authority with respect to a course of training, each assistant chief instructor authorized to administer tests or checks pursuant to that course of training, as a result of the successful completion of which a student may be recommended for a certificate under GACAR § 141.123, must be designated by the President under GACAR Part 183.</td><td>□</td><td>□</td></tr><tr><td>(b)</td><td>For a course of training leading to the issuance of a private pilot certificate or rating, an assistant chief instructor must have—</td><td>□</td><td>□</td></tr><tr><td>(1)</td><td>At least 500 hours as PIC; and</td><td>□</td><td>□</td></tr><tr><td>(2)</td><td>Flight training experience, acquired as either a certificated flight instructor or an instructor in a military pilot flight training program, or a combination thereof, consisting of—</td><td>□</td><td>□</td></tr><tr><td>(i)</td><td>At least 1 year and a total of 250 flight hours or</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>At least 500 flight hours.</td><td>□</td><td>□</td></tr><tr><td>(c)</td><td>For a course of training leading to the issuance of an instrument rating or a rating with instrument privileges, an assistant chief flight instructor must have—</td><td>□</td><td>□</td></tr><tr><td>(1)</td><td>At least 50 hours of flight time under actual or simulated instrument flight conditions;</td><td>□</td><td>□</td></tr><tr><td>(2)</td><td>At least 500 hours as PIC; and</td><td>□</td><td>□</td></tr><tr><td>(3)</td><td>Instrument flight instructor experience, acquired as either a certificated flight instructor instrument or an instructor in a military pilot flight training program, or a combination thereof, consisting of—</td><td>□</td><td>□</td></tr><tr><td>(i)</td><td>At least 1 year and a total of 125 flight hours or</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>At least 200 flight hours.</td><td>□</td><td>□</td></tr><tr><td>(d)</td><td>For a course of training other than one leading to the issuance of a private pilot certificate or rating, or an instrument rating or a rating with instrument privileges, an assistant chief instructor must have—</td><td>□</td><td>□</td></tr><tr><td>(1)</td><td>At least 1 000 hours as PIC; and</td><td>□</td><td>□</td></tr><tr><td>(2)</td><td>Flight training experience, acquired as either a certificated flight instructor or an instructor in a military pilot flight training program, or a combination thereof, consisting of—</td><td>□</td><td>□</td></tr><tr><td>(i)</td><td>At least 1.5 years and a total of 500 flight hours or</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>At least 750 flight hours.</td><td>□</td><td>□</td></tr><tr><td>(e)</td><td>To be eligible for designation as an assistant chief instructor for a ground school course, a person must have at least 6 months of experience as a ground school instructor at a certificated pilot school.</td><td>□</td><td>□</td></tr></table> C. FOR GACA USE ONLY <table><tr><td>Nominated Assistant Chief Instructors</td><td>□ Accepted</td><td>□ Rejected</td></tr></table> GACA-AVSES-OPS-F023 Rev: 3, Date: 22 Jun 25 Page 2 of 3 GACA الهييه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] ASSISTANT CHIEF INSTRUCTORS ACCEPTANCE APPLICATION FORM GACAR PART-141 Remarks (if rejected only) <table><tr><td>Aviation Safety Inspector Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td></tr></table> Supporting Documents 1. This application form; 2. Flight School/Organization nomination official letter; 3. Copy of Applicant (Nominee) C.V; 4. Copy of applicant valid License(s), Ratings, Medical, certificates, etc. 5. Prof of relevant experience 6. Copy of relevant training courses, as required 7. Copy of passport/ID 8. One personal photo GACA-AVSES-OPS-F023 Rev: 3, Date: 22 Jun 25 Page 3 of 3