2019 CJP Gold Standard Safety Award Application

Name: ___________________________________________________

Address: __________________________________________________

Email: ____________________________________________________

✓ I certify that I have flown 100 PIC Turbine hours between

August 1, 2018 and July 31, 2019.

TOTAL PIC Turbine Hours from 8/1/18 to 7/31/19: __________________

✓ I agree that I have read the CJP Standard Operating Practices (SOPs) and incorporated them in to my flying. INITIAL: _______________

✓ I also verify that I completed a 61.58 check at a Part 142 simulator

training provider on the following date between August 1, 2018 and July 31, 2019.

Please provide a copy of the completion certificate.

DATE: ______________________

✓ Describe and provide proof of completion of a second 61.58 at a Part 142 simulator training provider or

six (6) hours of Citation dual instruction in an aircraft or simulator between August 1, 2018 and July 31,

2019. Please provide a copy/copies of completion certificate(s). Description:__________________________________________________________________________ ____________________________________________________________________________________ Date of training: _______________________ Hours of dual: __________________________________ Date of training: _______________________ Hours of dual: __________________________________ Date of training: _______________________ Hours of dual: __________________________________ Date of training: _______________________ Hours of dual: __________________________________

✓ Describe and provide proof of completion of one of the following training events between

August 1, 2018 and July 31, 2019. Please provide a copy/copies of completion certificate(s). Description:__________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Date of training: _______________________

• Ratings – sea, glider, rotor, ATP, warbird, LOA, etc.

• Endorsements – tailwheel or others• Physiology training

• Spin/aerobatic

• Upset recovery• Other aircraft 142 sim

• Specialty training – backcountry, FAST, etc.

• Ground school

• CJP Convention attendance

• Survival training, dunk tank

• FSI Pro Card (Elite)

• Other accredited aviation training

• CFI renewal• Discounted FlightSafety eLearning library courses Cold Weather or Warm Weather