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Checkride Information
Test Date & Time: No dates? Checkride Type: Is training complete now? Why this? IACRA/Endorsements done? Why this? Initial or Add-on? What's this? Location (Airport): First name
Last name
Phone Number: Address: City: State: Zip: Email: Current Certificate: Certificate Number: Certificate Date (MM/DD/YYYY)
FTN: What's this? Medical Type: Medical Date (MM/DD/YYYY)
Age When Medical Obtained CFI First name
CFI Last name
CFI Phone Number: CFI Email: CFI Certificate Number: Supervisor Email (Optional) What's this?: FAR Part: Aircraft Model: Tail Number: Flight School: Is this a Retest?: Comments:


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