Free FTP-001 - Federal

FLIGHT TEST PILOT Supplemental Questionnaire

NAME: ________________________________________ SSN: ________________________________________

DATE: ___________________

Please circle the correct response and provide the information requested. This information will be used to determine your eligibility for Flight Test Pilot positions.

1. I have a degree in engineering from an accredited college or university. School: ____________________ Degree: __________ Date: __________ 2. I am a graduate of a full-term flight test pilot school. If yes, provide graduation date (month/year) for the school you attended. a. Britain _______________ _ b. Edwards AFB _________ _ c. France ______________ _ d. NTPS (1 year) __________ d. Patuxent River NATC _____________ f. Russia _________________________ g. Other __________________________ School Name/Graduation Date) (

Yes

No

Yes

No

3. I have airplane flight test pilot experience. If yes, list the number of airplane flight test Yes pilot hours. a. Aircraft over 12,500 lb. _______________

No

b. Aircraft under 12,500 lb. _______________ 4. I have airplane pilot-in-command experience in aircraft with the following types of engines. If yes, list the number of flight hours. a. Turbo fan engines b. Turbo jet engines _______________ _______________ Yes No

c. Turbo prop engines _______________ 5. I have airplane flight test pilot experience in aircraft with the following types of engines. Yes If yes, list the number of flight hours. a. Turbo fan engines b. Turbo jet engines _______________ _______________ No

c. Turbo prop engines _______________

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6. I have helicopter flight test pilot experience. If yes, list the number of helicopter flight test pilot hours. a. Helicopter over 12,500 lb. _______________

Yes

No

b. Helicopter under 12,500 lb. _______________ 7. I am currently a flight test pilot. If not, list the date you last held a flight test pilot position. Month/Year _______________ 8. I have flight test experience in transport aircraft. 9. I have held the position of flight test pilot in civilian industry. 10. I have been involved as a flight test pilot in the type certification (TC) of the following Federal Aviation Regulations: a. FAR 23 (Airplane) _________ _ b. FAR 25 (Airplane) _________ _ c. FAR 27 (Helicopter) __________ d. FAR 29 (Helicopter) __________ Yes No Yes Yes No No Yes No

11. I have managed a flight test organization. I managed the following number of employees: a. 1-5 b. 6-10 _________ _ _________ _ d. 21-30 ______________ e. 31 or more __________

c. 11-20 __________ 12. I have served as a group or team leader over flight test project(s) involving aircraft redesign, reengineering, critical modifications, airworthiness, etc. lasting 4 months or more. The team included the following number of members: a. 1-5 b. 6-10 _________ _ _________ _ d. 21-30 ______________ e. 31 or more __________ Yes No

c. 11-20 __________ 13. I have worked on cross-organizational projects involving multi-service aircraft or multi- Yes mission aircraft. 14. I have worked with designers and/or manufacturers' representatives on projects involving new or critically modified aircraft. The project(s) lasted a. 0-6 mo. _________ _ b. 7-12 mo. _________ _ c. 13-24 mo. ______________ d. 25 or more mo. __________ Yes No

No

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15. I am or have been a member of an aviation organization; e.g., Society of Experimental Yes Test Pilots, Society of Flight Test Engineers, etc. 16. I have served as a chapter or national officer of such an aviation organization. 17. I have received significant recognition, such as an award, from an aviation organization. I was recognized primarily for a. Program/project management b. Team participation on a program/project __________ __________ Yes Yes

No

No No

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 Atlanta, GA Chicago, IL Wichita, KS Burlington, MA Kansas City, MO Long Island, NY Fort Worth, TX Seattle, WA

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.

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