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Complete this form to request an appointment for an Initial Flight Instructor Practical Examination. When we process your application, you'll receive your test assignment in the U.S. Mail. Expect our reply in 3 to 5 working days.

* indicates required field

Instructor Information

*Name:
*Certificate Number:
Attended FSDO CFI/ESP Program?	No Yes

School/Facility Information

*School Name:
*Street Address:
*City:
*State:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
*Zipcode:
*Fax Number:	( ) –
*Phone Number:	( ) –

Applicant Information

*Name:
*Certificate Number:
Attended FSDO CFI/ESP Program?	No Yes
*Street Address:
*City:
*State:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
*Zipcode:
*Fax Number:	( ) –
*Phone Number:	( ) –
*Email:
*U.S. Citizen?	No Yes

Test Information

*Initial Test Requested:
*Aircraft to be Used:
*Is this a retest?	No Yes
If retest, what number?
*Point of Contact	Instructor Applicant
*Your Email

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