Apply for the position PILOT DETAILS □ Airline Captain First Name (Given Middle Last Name Name) Name(s) (Family Name) Present Nationality Passport picture with white background and no hat / no glasses) Languages spoken Gender (Indicate Ability) Date of Country of Birth(DD/MM/YYYY) Birth Religion Skype Marital Status Home Tel. No E-mail Please enter mobile and/or home Cell Phone No. telephone number in (Country Code + Area Code + Telephone Number) Current Address □A320 Apply for Aircraft Type Physical status Heights in CMs Weights in KGs □ Print Media □ Internet □Agency □ Career Fair □ Referral □ How did you learn about this job advertisement? Beijing(full) Which base do you prefer? Xi’an Guangzhou Hangzhou Haikou Other Sanya Highest Education Degree ICAO English Proficiency level on License and Valid Until (D/M/Y) Primary Passport National ID/ Passport No. Nationalit y Country of Issue Date of issue (D/M/Y) Date of Expiry(D/M/Y) Is there any limitation on the licence?If "yes", please list the detailed information………………………….. TOTAL FLYING HOURS IN YOUR CAREER: (H) F/E, Navigator or Date Of Last SIM Aircraft Total Time Type Captain hours First Officer Hours Second-Officer Check.Last Proficiency Check Hours and most recent flight(D/M/Y) TOTAL FLYING LAST 6 MONTHS Aircraft Date First Date Last Captain First Officer Type Flown (D/M/Y) Flown(D/M/Y) hours Hours F/E, Navigator or Second-Officer Hours "Captain Hours" should only include the time when operating as the nominated Commander., i.e. it is you on the Flight Plan as PIC (Pilot in Command). Cruise Captain Time (CRZ CAPT), should be entered under “First Officer Hours”. First Officers should enter all hours under “First Officer Hours” (regardless of the capacity they were operating in – PF / PM). Second Officers, Navigators and F/E should enter all their hours under “Second Officer Hours” (regardless of the capacity they were operating in). Training Qualifications Company Name Aircraft Types Training Type Specify Approvals (TRE,TRI,CRE,CRI,FI) i.e. Line Base,Sim, CAA,FAA TRE: Type Rating Examiner; TRI: Type Rating Instructor; CRE: Class Rating Examiner; CRI: Class Rating Remark Instructor; FI: Flight Instructor; LTC: Line Training Captain. Medicals Information Class Date of issue (D/M/Y) Date of Expiry (D/M/Y) Do you hold a Class 1 Medical without restriction other than for visual correction? ………………………….. Since your last medical certiflcate was issued, have you sulfered with any medical condition which could affect your fitness to fly? ……………………………………………………………………… If yes, please provide full details of when and for what medical condition. ……………………………………………………………………… EMPLOYMENT HISTORY Current Airline From To Position Aircraft Type Please include details of your current and all previous work experience, starting with the most recent one. Please cover at least 5 years of work experience or until your graduation. If you have any periods of unemployment or training please list these as “UNEMPLOYED” or “TRAINING” to provide a continuous career history. Are you currently working for a Chinese Airline? ………………………….. Have you even been invited by any of the HNA Group affiliated airlines or entities? ……………………….. Have you even been participated in a selection process by any other Chinese Airline? ………………………….. Have you worked for Chinese Airlines or obtained Chinese License in the past? ……… If any of the above is answered with "YES", please specify either for which airline you are working and the selection date. Also state the result of this application / invitation and why and when you did not join. ……………………………………………………………………… Have you ever had any aircraft accidents orincidents? ………………………………………… Do you have a criminal record? ……………… Availability for next two months: …………………………………………………………..… Monthly Salary in your current company: (USD) -------------------------------------------------------------------------------------------------------------------------------------------------------------How did you get this recruitment information?______________(Write the option here ) A. Job Roadshow B. Smile Aviation Website (If not, other website:_________________________) C. Facebook D. Linkedin E. Wechat F. Newsletter G. Referral (please write down this person’s details as below) Name:____________________ Position:__________________ Company:_________________ Email:____________________ Phone:___________________ H. Other______________________ Why left your last job or want to leave your current job Pls rPlease rank the items which you care most when choosing jobs(line up in numeric order) Commuting/ Base/ Salary/ Company environment/ other:_____________ 1._________ 2._________ 3._________ 4._________ 5.________ Have you even been participated in a selection process by any other Chinese Airline?………………………….. Yes. Which airline?___________ When?___________ What position?________ No. What tests did you do for the screening in last Chinese airlines? Remark: If you did have screening experience with Chinese airlines before, pls be candid to us in case any documents we need to access from your previous screening company to facilitate the process with next airlines. Otherwise, any delay or cancellation of the process due to candidate’s deliberate concealing, the candidate himself should cover the occurred expenses. ATPL? Pass?/fail?_______, Score?_______. (Send us scan copy of the transcript.) Medical Check-up? Pass?/fail?_______. State reason in case of failure or cease. Airline Simulator Check? Pass?/fail?_______ CAAC Simulator Check? Pass?/fail?_______ Why you stopped the screening process? Medical History Form (See below) Please answer the following questions. Answer “yes” or “no” for every condition listed below with “√”. Y (1)mental disorders 精神障碍 (2) unconsciousness, faint 昏迷,晕倒 N Y N (15) Gastrointestinal diseases Y (29) wear lens/glasses 佩戴眼镜 胃肠疾病 (30) frequent usage of sleeping medicine (16) diabetes 糖尿病 or tranquiliser 频繁使 用安眠药物或镇定剂 (3) Inflight or ground incapacitation 空中或地面失能 (17) allergic diseases 过敏性疾病 (31) current usage of drugs 目前使用药物 (4) epilepsy or convulsion 癫痫或抽搐 (18) cholelith or gall system disease 胆道结石或胆系疾病 (32) infectious disease 传染病 (5) frequent or severe headache 经常或严重的头痛 (19) kidney stone or hematuria 泌尿系结石或血尿 (33) hospitalizing history in recent 1 years 近一年住院史 (6) head injury 头颅外伤 (20) history of injury or surgery operation 手术或外伤史 (7) insomnia, agrypnia (21) pains of waist, back, or lamb joints 睡眠不良,失眠 腰背四肢关节痛 (8) flight illusion (22) gynecology diseases 飞行错觉 妇产科疾病 (9) abnormal feeling of limbs 肢体感觉异常 (10) accident or accident symptom of flight 飞行事故或事故征 候 (11) alcohol or substance dependence or abused 物质依赖或滥用 (12) Precordial distress or Heart disease 心前区不适或心脏 病 (13) Hypertension or hypotension 高血压或低血压 (34) vacation or rehabilitasion after illness in recent 1 years 近一年疗养史 (35) fatigue 疲劳感 √ (36) smoking 抽烟 (23) tinnitus or hearing loss 听力下降或耳鸣 (37) others 其它 (24) pneumatic trauma of Ears (38) Family History of Certain Diseases(first time application only) 压耳 首次申请时填写以下 疾病家族史 (25) motion sickness 晕机 a cardiovascular diseases 心血管疾病 (26) vertigo, dizziness 头晕 b diabetes 糖尿病 (27) Dysopia or oculopathy 视觉障碍或眼部疾病 c epilepsy 癫痫 N (14) Asthma or pneumopathy 哮喘或肺脏疾病 (28) surgery of myopia 近视眼手术矫治 d mental diseases 精神病 Description for all the items that marked “YES”: If you have any kind of surgery (which leaves permanent scars or anything obvious in your body)before, please state when was the surgery, what was the condition, what kind of surgery and the recovery and also bring English/Chinese version of surgical report. * I hereby declare that: • I have not been convicted of criminal offence or been declared bankrupt in any country. • The particulars in this application form and document(s) attached hereto are true in every respect. • I have not willfully suppressed any material fact. I’ll be represented by Capital airlines. Name: Signed: Date: