DPRE SUPPLEMENTAL INFORMATION
This sample document, or a similar format may be used to provide supplemental information to support eligibility, and qualifications for appointment as a FAA Designated Parachute Rigger Examiner (DPRE).
Describe your experience that pertains to qualifications for a Designated Parachute Rigger Examiner (DPRE). Please be detailed in your responses in order to support your experience. Refer to FAA Order 8000.95 Designee Management System, Volume 5 for minimum experience requirements for a DPRE. You may attach additional experience pages as necessary.
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Name of Employer/Organization: |
Telephone Number: |
Street Address: |
City: |
State (Country if other than USA): |
Zip/Postal Code: |
Job/Position Title: |
Dates Employed: From: ________________ To:___________________ |
Supervisor’s Name: |
FAA Air Agency or Air Operator Certificate Number (If applicable): |
Experience (add additional pages if needed): |
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Name of Employer/Organization: |
Telephone Number: |
Street Address: |
City: |
State (Country if other than USA): |
Zip/Postal Code: |
Job/Position Title: |
Dates Employed: From: ________________ To:___________________ |
Supervisor’s Name: |
FAA Air Agency or Air Operator Certificate Number (If applicable): |
Experience (add additional pages if needed): |
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Name of Employer/Organization: |
Telephone Number: |
Street Address: |
City: |
State (Country if other than USA): |
Zip/Postal Code: |
Job/Position Title: |
Dates Employed: From: ________________ To:___________________ |
Supervisor’s Name: |
FAA Air Agency or Air Operator Certificate Number (If applicable): |
Experience (add additional pages if needed): |
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Name of Employer/Organization: |
Telephone Number: |
Street Address: |
City: |
State (Country if other than USA): |
Zip/Postal Code: |
Job/Position Title: |
Dates Employed: From: ________________ To:___________________ |
Supervisor’s Name: |
FAA Air Agency or Air Operator Certificate Number (If applicable): |
Experience (add additional pages if needed): |
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Name of Employer/Organization: |
Telephone Number: |
Street Address: |
City: |
State (Country if other than USA): |
Zip/Postal Code: |
Job/Position Title: |
Dates Employed: From: ________________ To:___________________ |
Supervisor’s Name: |
FAA Air Agency or Air Operator Certificate Number (If applicable): |
Experience (add additional pages if needed): |
FAA Certificates Held
Provide the details of any FAA certificates held. For repairman certificates, also include the limitations stated on the certificate in the “RATINGS” column.
CERTIFICATE TYPE |
CERTIFICATE NUMBER |
RATINGS |
DATE OF ISSUANCE |
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Fixed Base of Operation
Address of applicant’s fixed base of operation equipped to support testing for parachute rigger certification.
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Applicant’s Name__________________________________________________ |
Author | DOT/FAA |
File Modified | 0000-00-00 |
File Created | 2024-10-28 |