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VI. SPECIALIZED KNOWLEDGE AND EXPERIENCE: 1. If application is for a position requiring aeronautical experience answer the following in detail: (a)Total solo hours Last 12 months Last 36 months (b) Where did you receive your training Year 2. Give certificate, weight, and engine classifications, and any special ratings now held by you. Fill in the required information including "INSTRUCTOR RATING."* [[4 Columned Table]] | Weight and engine classification | Past 12 months | Past 36 months | Pilot certificate | |---|---|---|---| (a) INSTRUMENT RATING Scheduled Nonscheduled Other (b) Total all instruction (c) Total all instrument 3. State aeronautical military or service connection, together with rank and ratings which you hold 4. Give number of solo hours appropriate to each weight and engine classification:* [[4 Columned Table]] | Weight and engine classification | Past 12 months | Past 36 months | Total | |---|---|---|---| 5. Give weight and engine classification and other ratings previously held:* [[3 Columned Table]] | Rating | Date originally obtained | Date lapsed | |---|---|---| 6. What mechanic certificate do you hold? Aircraft mechanic (Yes or no) Number Aircraft engine mechanic (Yes or no) Number 7. Attach a general description of your aeronautical experience with reference to: (a) Your flying experience. (b) Your experience as an instructor. (c) Other. 8. Attach a detailed description of your aeronautical experience concerning research, design, construction, inspection, maintenance, and repair. 9. List any professional societies or associations of which you are a member 10. List any articles or books you have published. (Submit copies or indicate where copies are available) 11. What foreign languages can you translate readily? 12. To what organizations or clubs do you belong? VII. Give five references other than relatives or employers: [[3 Columned Table]] | FULL NAME | FULL ADDRESS | OCCUPATION | |---|---|---| *If necessary attach a detailed statement concerning this item. 16-8177 (3)