Members Name:

 

DPC Number: Aircraft Number: Check Date:
Type of Checkout (Check blocks satisfactorily completed)

 ___  INITIAL                            ___  INSTRUCTOR                    ___  NIGHT ORIENTATION     ___  FAA BFR
 ___  STUDENT PRE-SOLO     ___  INSTR. COMPETENCY    ___  INSTRUMENT                    ___  OTHER:
 ___  ANNUAL                          ___  MULTI-ENGINE                ___  AIRCRAFT CHECKOUT             _______
 
Review of Certificates and Documents (Verified by Check Pilot)

FAA Pilot Certificate No. _______________________         FAA BFR (or AFR) Date: ______________

FAA Class: ____________________                                        Medical Issue Date: __________________
I certify that I have administered a DPC flight check as indicated and that the above named member:

 ___  Has demonstrated the proficiency required to fly the indicated aircraft.
 ___  Has demonstrated the proficiency required to be a DPC Flight Instructor.
 ___  Has demonstrated instrument competency.
 ___  IS NOT QUALIFIED.  REQUIRES ADDITIONAL TRAINING AND A RECHECK.
 
Comments:

 

Check Pilot's Name/Certificate Number:

 

Check Pilot Signature: Flight Time: Date:
I certify that I have read and understand all applicable FAA, DPC and STATE regulations pertaining to flying subject
aircraft.  I acknowledge any restrictions or training requirements stated above.  I also understand that maintaining
currency, recurring requirements and compliance with applicable directives is my personal responsibility.  I certify
that I am not taking any medication or other substances that would prohibit me from acting as Pilot In Command.

Members Signature: ___________________________________              Date:  ___________
 

INSTRUCTIONS:
Ground phase may be completed separately within a 30-day period before flight check.  All items must be completed
indicating S - Satisfactory, U - Unsatisfactory, V - Verbally or NA - Not Applicable.  If a member can satisfactorily
perform the more complex maneuvers, less complex maneuvers need not be accomplished at the discretion of the
check pilot.  Night orientation is for familiarization only.  Pilots are evaluated on their ability to satisfactorily
perform the tasks assigned,  knowledge of procedures, smoothness, judgment, and mastery of the aircraft.  Failure
to meet the standards of performance for any task performed will result in an unsatisfactory evaluation.  Tolerances
specified in the FAA Private Practical Test Standards represent the minimum performance expected in good flying
conditions.  Individuals holding an Instrument rating (or ATP certificate) are required to demonstrate instrument
competency on a DPC check flight or be restricted from exercising instrument privileges in DPC Aircraft.

GENERAL PILOT INFORMATION
A DPC flight check must be taken and passed to:
     1.  Fly PIC in DPC aircraft without a DPC instructor.
     2.  Fly IFR in DPC aircraft.

The flight check must be taken in the most complex DPC aircraft to be flown at the highest rating to be used in DPC
aircraft.  An FAA rating check ride will not fulfill the requirements of this check.

 
.
 




PILOTS CHECK LIST
   I.   DPC ORAL DISCUSSION
   ___ A.  DPC Written Exam Passed
   ___ B.  Review of Regs and DPC policies
                 and Operating Rules.
   ___ C.  Review of A/C Limitations.
   ___ D.  Review of Pilot Limitations
   ___ E.  Local Procedures.

  II.   PRE-FIGHT PREPARATION
   ___ A.  Certificates and Documents.
   ___ B.  Obtaining Weather Information.
   ___ C.  Determine Performance and Limitations.
   ___ D.  Cross-Country Flight Planning.
   ___ E.  Airplane Systems.
   ___ F.  Aeromedical Facts.

 III.   GROUND OPERATIONS
   ___ A.  Visual Inspection.
   ___ B.  Cockpit Management.
   ___ C.  Starting Engine.
   ___ D.  Taxing.
   ___ E.  Pre-takeoff Check.
   ___ F.  Post-flight Procedures.

  IV.   AIRPORT & TRAFFIC PATTERN OPS
   ___ A.  Radio Comm & ATC Light Signals.
   ___ B.  Traffic Pattern Operations.
   ___ C.  Airport & Runway Markings/Lighting.

   V.   TAKEOFFS AND CLIMBS
   ___ A.  Normal Takeoff and Climb.
   ___ B.  Crosswind Takeoff and Climb.
   ___ C.  Short-field Takeoff and Climb.
   ___ D.  Soft-field Takeoff and Climb.

  VI.   CROSS-COUNTRY FLYING
   ___ A.  Pilotage and Dead Reckoning.
   ___ B.  Radio Navigation.
   ___ C.  Diversion.
   ___ D.  Lost Procedures.
   ___ E.  Airspace.

 VII.   INSTRUMENT REF. MANEUVERING
   ___ A.  Straight and Level Flight.
   ___ B.  Straight Constant Airspeed Climbs.
   ___ C.  Straight Constant Airspeed Descents.
   ___ D.  Turns to Heading.
   ___ E.  Unusual Flight Attitudes.
   ___ F.  Radio Nav and Radar Services.

VIII.   FLIGHT AT SLOW AIRSPEEDS
   ___ A.  Full Stalls - Power Off.
   ___ B.  Full Stall - Power On.
   ___ C.  Imminent Stalls - Power On/Off..
   ___ D.  Maneuvering At Slow Airspeed.
   ___ E.  Constant Altitude Turns.

  IX.   GROUND REFERENCE MANEUVERING
   ___ A.  Rectangular Course.
   ___ B.  S-Turns Across a Road.
   ___ C.  Turns Around a Point.

   X.   NIGHT FLIGHT OPERATIONS
   ___ A.  Preparation and Equipment.
   ___ B.  Night Flight.

  XI.   EMERGENCY OPERATIONS
   ___ A.  Emergency Approach & Landing.
   ___ B.  System and Equipment Malfunction..
   ___ C.  Engine Failure on Takeoff.

 XII.   APPROACHES AND LANDINGS
   ___ A.  Normal Approach & Landing.
   ___ B.  Crosswind Approach & Landing.
   ___ C.  Forward Slips to Landing.
   ___ D.  Go-Around.
   ___ E.  Short-Field Approach & Landing.
   ___ F.  Soft-Field Approach & Landing.

XIII.   INSTRUMENT COMPETENCY
   ___ A.  Ground Prep
(Weather, Aircraft Sys & Flt Planning)
   ___ B.  Air Traffic Procedures.
   ___ C.  Compliance With ATC Clearances.
   ___ D.  Holding Procedures.
   ___ E.  Flight by Reference to Instruments.
                  Straight/Level, Climb/Descent, Timed/
                  Steep Turns & Airspeed Control
   ___ F.  Unusual Attitude Recovery - Partial Panel.
   ___ G.  Intercept/Track VOR/NDB Radials.
   ___ H.  Instrument Approach Procedures:
   ___       1.  ILS/MLS Approach.
   ___       2.  VOR/VORTAC Approach.
   ___       3.  NDB Approach.
   ___       4.  Circling Approach Procedures.
   ___       5.  Missed Approach.

 XIV.  SAFETY AWARENESS
   ___ A.  Clearing Turns.
   ___ B.  Vigilance.
   ___ C.  Fuel Management.

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