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GACA المنيه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] 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 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 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 Chief Instructors) Experience</td></tr><tr><td colspan="4">Work Experience Relevant to 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 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-F022 Rev: 3, Date: 22 Jun 25 Page 1 of 3 GACA العلنيه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] CHIEF INSTRUCTORS ACCEPTANCE APPLICATION FORM GACAR PART-141 <table><tr><td colspan="4">B. ASSISTANT CHIEF INSTRUCTORS REQUIREMENTS</td></tr><tr><td colspan="2">GACAR PART-141.57 Assistant Chief Instructor Qualifications</td><td>YES</td><td>NO</td></tr><tr><td>(a)</td><td>To be eligible for designation as a 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 certificate or an ATP certificate, and, except for a 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 and class ratings for the category and class of aircraft used in the course and an instrument rating, if an instrument rating is required for enrollment in the course of training;</td><td>□</td><td>□</td></tr><tr><td>(2)</td><td>Meet the pilot in command (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 Kingdom of Saudi Arabia (KSA) Aeronautical Information Publication (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 chief instructor.</td><td>□</td><td>□</td></tr><tr><td>(4)</td><td>Pass a proficiency test on instructional skills and ability to train students on the flight procedures and maneuvers appropriate to the course;</td><td>□</td><td>□</td></tr><tr><td>(5)</td><td>Except for a course of training for gliders, balloons, or airships, the chief instructor must meet the applicable requirements in paragraphs (b), (c), and (d) of this section;</td><td>□</td><td>□</td></tr><tr><td>(6)</td><td>A 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; and</td><td>□</td><td>□</td></tr><tr><td>(7)</td><td>If the pilot school has or seeks examining authority with respect to a course of training, each chief instructor is 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, a 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>Primary 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 2 years and a total of 500 flight hours; or</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>At least 1 000 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, a chief instructor must have—</td><td>□</td><td>□</td></tr><tr><td>(1)</td><td>At least 100 hours of flight time under actual or simulated instrument flight conditions;</td><td>□</td><td>□</td></tr><tr><td>(2)</td><td>At least 1 000 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 2 years and a total of 250 flight hours; or</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>At least 400 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, a chief instructor must have—</td><td>□</td><td>□</td></tr><tr><td>(1)</td><td>At least 2 000 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 3 years and a total of 1 000 flight hours; or</td><td>□</td><td>□</td></tr><tr><td>(ii)</td><td>At least 1 500 flight hours.</td><td>□</td><td>□</td></tr><tr><td>e.</td><td>To be eligible for designation as chief instructor for a ground school course, a person must have at least 1 year of experience as a ground school instructor at a certificated pilot school.</td><td>□</td><td>□</td></tr></table> GACA-AVSES-OPS-F022 Rev: 3, Date: 22 Jun 25 Page 2 of 3 GACA الهييه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] CHIEF INSTRUCTORS ACCEPTANCE APPLICATION FORM GACAR PART-141 C. FOR GACA USE ONLY <table><tr><td>Nominated Chief Instructors Post Holder</td><td>□ Accepted</td><td>□ Rejected</td></tr><tr><td colspan="3">Remarks (if rejected only)</td></tr><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 passport/ID 7. One personal photo GACA-AVSES-OPS-F022 Rev: 3, Date: 22 Jun 25 Page 3 of 3