Flight Test Pilot Supplemental Questionnaire Template Page 3
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315. I am or have been a member of an aviation organization; e.g., Society of Experimental
Yes
No
Test Pilots, Society of Flight Test Engineers, etc.
16. I have served as a chapter or national officer of such an aviation organization.
Yes
No
17. I have received significant recognition, such as an award, from an aviation
Yes
No
organization. I was recognized primarily for
a. Program/project management
__________
b. Team participation on a program/project
__________
c. Technical aspects of flight test operations __________
d. Other (Specify) _______________________________
GEOGRAPHIC CODE LIST
Please mark all of the locations where you would like to be considered for employment. You will only be
referred for employment consideration for the locations you select.
Long Beach, CA
Kansas City, MO
Atlanta, GA
Long Island, NY
Chicago, IL
Fort Worth, TX
Wichita, KS
Seattle, WA
Burlington, MA
PRIVACY ACT AND PUBLIC BURDEN STATEMENT
Public Law 104-50 allows the Federal Aviation Administration (FAA) to rate applicants for employment. We need the information on
this application questionnaire to see how well your education and work skills qualify you for employment with the FAA. We also
need information on matters such as citizenship and military service to see whether you are affected by laws we must follow in
deciding whom the Federal government may employ.
Executive Order 9397 authorizes the solicitation of your Social Security Number (SSN) for use as an identifier in personnel records
management to assure proper identification of applicants throughout the selection and employment process. The information we
collect on this questionnaire, including your SSN, will be used for employment purposes, and it may also be used for statistical
studies or computer matching with other government files. Furnishing your SSN or any of the other information requested in the
vacancy announcement is voluntary; however, failure to provide this information will prevent the processing of your application and
will prevent your consideration for employment. The nature of the information received is confidential, and authorized officials will
handle it appropriately. This information becomes part of a Privacy Act System of Records as identified in 5CFR 552a, under
OPM/GOVT-1: General Personnel Records.
We estimate it will take you 30 minutes or less to complete this form, including the time required to read the instructions, provide the
requested information, and review your responses. Send comments regarding this estimate or any other aspect of the collection of
information, including suggestions for reducing the burden, to the Federal Aviation Administration, Assistant Administrator for
Human Resource Management, 800 Independence Avenue, SW, Washington, D.C. 20591.
FTP-001 (3/99)
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