Federal Department of the Environment, Transport, Energy and

Communications DETEC
Federal Office of Civil Aviation FOCA
Safety – Division Flight Personnel
3003 Bern

Skill test Applicant's licence number:

PPL(A) Application and report form

Applicant last name: first name: date of birth:

place of birth: place of origin: nationality:

private address: postal code: city: street:

phone/fax home: phone/fax office:

e-mail:

 initial skill test  repetition of failed / partial passed skill test, from date:

 conversion to an EASA licence  upgrade from LAPL(A) to PPL(A)

Instructor last name: first name:

licence number: signature of flight instructor:

The ATO confirms that the candidate has been trained according to the approved syllabus and assures the level of proficiency required.

ATO/DTO name: registration number:

name of head of training: licence number:

location & date: signature of head of training:

1 Details of flight

date: type of aeroplane: registration: class: TR:

departure/destination block-off: block-on: block time: # of landings:

2 Result of skill test *delete as necessary Applicant's signature

pass* fail* partial pass*

3 Remarks

Examiner: last name: first name:

examiner authorisation: licence number:

location and date: signature of flight examiner:

FOCA/EASA Form 60.220 03.2019 EASA AMC1 FCL.235 1/6

BAZL OFAC UFAC FOCA CH-3003 Bern (Switzerland)

Applicant's licence number:

Instruction / experience report

A copy of the relevant logbook pages (flight experience & STD pages) showing the confirmed completion of the
flight instruction must be attached to this form. Please make sure to note your licence number together with your
signature at the bottom of the pages.

Summary of conditions and flying experience for PPL(A) skill test

a) Applicants minimum age: 17 years

b) Enclose copy of passport 

c) EASA Medical class  1 or  2 valid until:

d) Theoretical examination PPL(A) passed date:

e) VFR radiotelephony practical test passed date:

Language proficiency MNM level 4 if applicable valid until:

f) Total flight experience according PART FCL.210.A

(incl. FSTD)

(Crediting: Holders of pilot licences for another category of

aircraft, with the exception of balloons, shall be credited with
10% of their total flight time as PIC on such aircraft up to a
maximum of 10 hours. A copy of the relevant logbook pages
must be submitted.)

(MNM 45 HR) hours:

g) Dual instruction (MNM 25 HR) hours:

of which
instruction time FSTD (MAX 5 HR) hours:

h) Solo instruction (MNM 10 HR) hours:

of which
solo cross country (MNM 5 HR) hours:

Leg 1 DEP DEST KM

Leg 2 DEP DEST KM

Leg 3 DEP DEST KM

total (MNM 270 Km great circle distance) KM

Additional training required for night qualification :

i) Night flight experience (MNM 5 HR) hours:

j) Dual instruction (MNM 3 HR) hours:

incl. dual cross country navigation (MNM 1 HR) hours:

Solo take-offs and landings (MNM 5) take-offs:

landings:

FOCA/EASA Form 60.220 03.2019 EASA AMC1 FCL.235 2/6

BAZL OFAC UFAC FOCA CH-3003 Bern (Switzerland)

Applicant's licence number:

Conduct of the skill test

An applicant shall pass all applicable sections. If any item in a section is failed, that section is failed. Failure in more than one section will
require the applicant to take the entire test again. An applicant failing only one section shall take the failed section again. Failure in any
section of the re-test, including those sections that have been passed on a previous attempt, will require the applicant to take the entire test
again. All sections of the skill test shall be completed within six months.

Further training may be required following any one failed skill test. Failure to achieve a pass in all sections of the test in two attempts will
require further training as determined by the Authority. There is no limit to the number of skill tests that may be attempted.

The Authority will provide the FE with adequate safety advice to ensure that the test is conducted safely.

Should the applicant choose to terminate a skill test for reasons considered inadequate by the FE, the applicant shall retake the entire skill
test. If the test is terminated for reasons considered adequate by the FE, only those sections not completed shall be tested in a further flight.

Any manoeuvre or procedure of the test may be repeated once by the applicant. The FE may stop the test at any stage if it is considered that
the applicant's demonstration of flying skills requires a complete re-test.

An applicant shall be required to fly the aeroplane from a position where the pilot-in command functions can be performed and carry out the
test as if there is no other crew member. Responsibility for the flight shall be allocated in accordance with national regulations.

The route to be flown for the navigation test shall be chosen by the FE. The route may end at the aerodrome of departure or at another
aerodrome. The applicant shall be responsible for the flight planning and shall ensure that all equipment and documentation for the
execution of the flight are on board.

An applicant shall indicate to the FE the checks and duties carried out, including the identification of radio facilities. Checks shall be
completed in accordance with the authorised check list for the aeroplane which the test is being taken. During pre-flight preparation for the
test the applicant is required to determine power settings and speeds. Performance data for take-off, approach and landing shall be
calculated by the applicant in compliance with the operations manual or flight manual for the aeroplane used.

The FE will take no part in the operation of the aeroplane except where intervention is necessary in the interests of safety or to avoid
unacceptable delay to other traffic.

Hinweis:
Innert 10 Tagen nach Zustellung des Ergebnisses des Skilltests/Proficiencychecks kann beim Bundesamt für Zivilluftfahrt, 3003 Bern,
schriftlich die Ausstellung einer beschwerdefähigen Verfügung über das Prüfungsresultat verlangt werden.

Remarque:
Il est possible, dans les dix jours suivant la communication du résultat du Skill Test/Proficiency Check d'obtenir, sur réquête écrite auprès de
l'Office fédéral de l'aviation civile, 3003 Berne, une décision susceptible de recours portant sur le résultat dudit examen.

Avviso:
Entro dieci giorni dall'invio dei resultati dello Skill Test/Proficiency Check può essere richiesta per iscritto all'Ufficio federale dell'aviazione
civile, 3003 Berna, una decisione impugnabile sull'esito dell'esame.

Remark:
Within 10 days after receipt of this skill test/proficiency check result, an appealable decision about the test / check results may be requested
in writing to the Federal Office of Civil Aviation, 3003 Bern, using one of the official languages (German/French/Italian)

FOCA/EASA Form 60.220 03.2019 EASA AMC1 FCL.235 3/6

BAZL OFAC UFAC FOCA CH-3003 Bern (Switzerland)

Applicant's licence number:

Use of checklist, airmanship, A/C limitations must be respected in all sections

Section 1 Pre-flight operations & departure
1 attempt 2 attempt
pass fail pass fail

a Pre-flight documentation NOTAM and Weather briefing

b Mass & balance and performance calculation

c Aeroplane inspection & servicing

d Engine starting and after starting procedures

Taxiing & aerodrome procedures, pre take-off

e
procedures

f Take-off and after take-off checks

g Aerodrome departure procedures

h ATC compliance & R/T procedures

please delete as necessary passed failed examiner's signature

Section 2 General airwork

1 attempt 2 attempt
pass fail pass fail

a ATC compliance & R/T procedures

b Straight and level flight with speed changes

Climbing:
c
i. Best rate of climb

ii. Climbing turns

iii. Levelling off

d Medium (30° bank) turns

Steep (45° bank) turns, including recognition & recovery

e
from a spiral dive

f Flight at critically low airspeed with and without flaps

Stalling:
g
i. clean stall and recover with power

Approach to stall in descending turn with bank

ii.
angle 20°, approach configuration

iii. Approach to stall in landing configuration

Descending:
h
i. With and without power

ii. Descending turns (steep gliding turns)

iii. Levelling off

please delete as necessary passed failed examiner's signature

FOCA/EASA Form 60.220 03.2019 EASA AMC1 FCL.235 4/6

BAZL OFAC UFAC FOCA CH-3003 Bern (Switzerland)

Applicant's licence number:

Use of checklist, airmanship, A/C limitations must be respected in all sections

Section 3 En-Route procedures

1 attempt 2 attempt
pass fail pass fail

a Flight plan, dead reckoning & map reading

b Maintenance of altitude, heading and speed

c Orientation, timing and revision of ETAs & log keeping

Diversion to alternate aerodrome (planning and

d
implementation)

e Use of radio navigation aids

Basic instrument flying check (180° turn in simulated

f
IMC)

g Flight management (checks, fuel systems & carburator

icing, etc.)

h ATC compliance & R/T procedures

please delete as necessary

passed failed examiner's signature

Section 4 Approach and landing procedures

1 attempt 2 attempt
pass fail pass fail

a Aerodrome arrival procedure

Precision landing (short field landing), Crosswind landing

b*
(if suitable conditions available)

c* Flapless landing

d* Approach to landing with idle power (SE only)

e Touch and go

f Go-around from low height

g ATC compliance & R/T procedures

h Actions after flight

please delete as necessary

passed failed examiner's signature

* this items may be combined at the discretion of the FE

FOCA/EASA Form 60.220 03.2019 EASA AMC1 FCL.235 5/6

BAZL OFAC UFAC FOCA CH-3003 Bern (Switzerland)

Applicant's licence number:

Use of checklist, airmanship, A/C limitations must be respected in all sections

Section 5 Abnormal & emergency procedures

1 attempt 2 attempt
(This section may be combined with Sections 1 to 4) pass fail pass fail

a Simulated engine failure after take-off (SE only)

b* Simulated forced landing (SE only)

c Simulated precautionary landing (SE only)

d Simulated emergencies

e Oral questions

please delete as necessary

passed failed examiner's signature

* this items may be combined at the discretion of the FE

Section 6 Simulated asymmetric flight and relevant class/type items

1 attempt 2 attempt
(This section may be combined with Sections 1 to 5) pass fail pass fail
Simulated engine failure during take-off (at a safe altitude
a
unless carried out in FFS)

b Asymmetric approach and go-around

c Asymmetric approach and full stop landing

d Engine shut down and restart

e ATC compliance, R/T procedures or airmanship

f As determined by the FE: any relevant items of the

class/type rating skill test to include, if applicable:

i. Aeroplane systems including handling of auto pilot

ii. Operation of pressurization system

iii. Use of de-icing and anti-icing system

g Oral questions

please delete as necessary

passed failed examiner's signature

By signing this form, I declare:

a) I do not possess a pilot licence, certificate, rating, authorisation or attestation with the same scope and in the
same category issued in another EASA Member State.
b) I have not applied for a pilot licence, certificate, rating, authorisation or attestation with the same scope and in the
same category issued in another EASA Member State.
c) I have never possessed any personnel licence, certificate, rating, authorisation or attestation with the same scope
and in the same category issued in another EASA Member State which was revoked or suspended in any other
EASA Member State.
d) that the information provided are correct. I am aware of the consequences of providing false information, such as
being denied a license, certificate, rating, authorisation or attestation, or having it revoked or cancelled.

Name: Signature of applicant:

Date and place:

FOCA/EASA Form 60.220 03.2019 EASA AMC1 FCL.235 6/6