Form 8710 Airman Certificate And Rating Application Page 4
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4Instructor's Recommendation
I have personally instructed the applicant and consider this person ready to take the test.
Date
Instructor's Signature
Certificate No:
Certificate Expires
Air Agency's Recommendation
The applicant has successfully completed our
course, and is
recommended for certification or rating without further
test.
Date
Agency Name and Number
Official's Signature
Title
Designated Examiner's Report
Student Pilot Certificate Issued (Copy attached)
I have personally reviewed this applicant's pilot logbook, and certify that the individual meets the pertinent requirements of FAR 61 for the pilot
certificate or rating sought.
I have personally reviewed this applicant's graduation certificate, and found it to be appropriate and in order, and have returned the certificate.
I have personally tested and/or verified this applicant in accordance with pertinent procedures and standards with the result indicated below.
Approved—Temporary Certificate Issued (Copy Attached)
Disapproved—Disapproval Notice Issued (Copy Attached)
Location of Test (Facility, City, State)
Duration of Test
Ground
Simulator
Flight
Certificate or Rating for Which Tested
Type(s) of Aircraft Used
Registration No.(s)
Date
Examiner's Signature
Certificate No.
Designation No.
Designation Expires
Evaluator's Record For Airline Transport Certificate/Rating Only
Inspector
Examiner
Signature
Date
Oral
Approved Simulator/Training Device Check
Aircraft Flight Check
Advanced Qualification Program
Inspector's Report
I have personally tested this applicant in accordance with or have otherwise verified that this applicant complies with pertinent procedures, standards,
policies, and or necessary requirements with the result indicated below.
Approved - Temporary Certificate Issued
Disapproved - Disapproval Notice Issued
Location of Test (Facility, City, State)
Duration of Test
Ground
Simulator
Flight
Certificate or Rating for Which Tested
Type(s) of Aircraft Used
Registration No.(s)
Student Pilot Certificate issued
Certificate or Rating Based
Instructor
Flight
Ground
Examiner's Recommendation
Military Competence
Renewal
Approved
ACCEPTED
REJECTED
Foreign License
Reinstatement
Disapproved
Reissuance or Exchange of Pilot Certificate
Approved Course Graduate
Instructor Renewal Based on
Special Medical test conducted - report forwarded
Other Approved FAA Qualification Criteria
Activity
Training
to Aeromedical Certification Branch, AAM-130
Certificate Issued
Acquaintance
Test
Certificate Denied
Training Course (FIRC) Name
Graduation Certificate No.
Date
Date
Inspector's Signature
FAA District Office
Attachments:
Student Pilot Certificate (copy)
Airman's Identification (ID)
Notice of Disapproval
Report of Written Examination
Superseded Pilot Certificate
Temporary Pilot Certificate (copy)
Answer Sheet Graded
Form of ID
Answer Sheet Graded
(Foreign Instrument)
Number
Expiration Date
NSN: 0052-00-682-5006
FAA Form 8710-1
(7-95) Supersedes Previous Edition
U.S. GPO:1995-715-783/83246
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