Form 8420-8 Application for Pilot School Certification

Paperwork Reduction Act Burden Statement: The information collected is used to certificate pilot schools. The information is required to determine qualification and compliance. A federal agency may not conduct or sponsor, and a person isnot required to respond to, nor shall a person be subject to a penalty for failure to comply with a
collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currentlyvalid OMB Control Number. The OMB Control Number for this information collection is 2120-0009. Public reporting for this collection of information is estimated to be approximately 30 minutes per
response, including the time for reviewinginstructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are mandatory per 14 CFR Part 141. Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden to the FAA at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information CollectionClearance Officer, AES-200.

APPLICATION FOR PILOT SCHOOL CERTIFICATION

US Department
of Transportation
Federal Aviation
Administration

Form approved: OMB No. 2120-0009

09/30/2012
CERT

APPLICANT - Read submittal and signature instructions on reverse.
NAME OF SCHOOL

For FAA Use Only

NO.

ADDRESS OF PRINCIPAL BUSINESS OFFICE

TELEPHONE NO.

LOCATION OF SATELLITE BASE(S)

LOCATION OF MAIN OPERATIONS BASE

APPLICATION IS HEREBY MADE FOR:
Issuance of a Pilot School Certificate and associated ratings to conduct the training courses identified below, and for the approval of these
courses (three copies of each course outline are attached); also, examining authority is requested for the courses appropriately checked.

Renewal of a Pilot School Certificate and associated ratings currently numbered

, which expires on

without changes to the currently approved course outlines,
with addition of course(s) identified below for which approval is requested (three
copies of each course outline is attached), including request for examining authority for the course(s) appropriately checked;
with deletion of course(s) identified below from the
curriculum.

, which expires on
Amending the current Pilot School Certificate and associated ratings numbered
by adding the course(s) identified below for which approval is requested (three copies of each course outline are attached), including request for
examining authority where appropriately checked;

for deletion of the course(s) identified below from the curriculum.
NOTE., Where examining authority for a course is desired, piece and "X"in the
box adjacent to the course identification. s

IDENTIFICATION OF TRAINING COURSES

(If more space is needed, continue on reverse in space provided)
I (WE) certify that I am (we are) familiar with Part 141 of the Federal Aviation Regulations, and, to the best of my (our) knowledge, believe that my (our) school meets the
requirements for certification as prescribed therein.

Signature
and Title(s)

Date

{

FOR FAA USE ONLY
APPROVED-

a Provisional Pilot School Certificate

a Pilot School Certificate, either with

DISAPPROVED

associated ratings bearing the number shown above is issued effective
and which expires on
Renewal
SIGNATURE OF APPROVING OFFICIAL

FAA Form 8420-8 (1-82)

without amendments

with amendments
TITLE

Amendments
DATE

Recommendations of Inspector(s) on reverse

INSTRUCTIONS TO THE APPLICANT:
Submit an original and one copy of this application, completed in full, along with the required number of attachments
where specified on the face of this form, to the FAA District Office having jurisdiction over the area in which the school
is located.
Signatures on the application should be as follows:
a. Application from a person acting as an individual should be signed by the owner;
b. Application from a partnership should be signed by all partners;
c. Application from a corporation should be signed by the president or such other officers as authorized by the
corporation by-laws to sign for the corporation and certified to by the corporate secretary attesting to the authority
of the individuals to sign such a document;
d. Application from a company, club, or association should be signed by the president or such other officer or
director as authorized by the organization's by-laws, and attested to by the secretary.
IDENTIFICATION OF TRAINING COURSES (Continued)

NOTE: Where examining authority for a course is desired, place and "X" in the
box adjacent to the course identification. s

THE FOLLOWING SPACE FOR FAA USE ONLY
Recommendations of Inspector(s)

INSPECTORS'
SIGNATURES
AND DATES

FOR OPERATIONS

FOR MAINTENANCE

FOR AVIONICS

DATE

DATE

DATE