Course Completion Please use the following form after completing a course at Phoenix East Aviation Select Campus*Please select the campusDaytona Beach (DAB)Broward (HWO)What campus is the student enrolled at? It is very important that you select the correct campus here to avoid any errors.Course Completion InformationStudent Name* First Last Please enter the full name as it appears on your Govt. Issued Photo IDAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please enter your full residential addressEmail* Phone*Instructor Name*Self or Non-Self Examining?*Self ExaminingNon-Self ExaminingCourse*PrivateInstrumentAAR Multi Engine (Private)AAR Multi Engine (Commercial)AAR Single EngineCPSETC 141.55CPMETC 141.55Commercial ASELCFIICFIMEIATPThis indicates that the final checkride will be an FAA Checkride with a DPE.Course*PrivateInstrumentAAR Multi Engine (Private)AAR Multi Engine (Commercial)Part 141 or Part 61?*14161Initial or Add-On?*InitialAdd-OnGraduation Date* Date Format: MM slash DD slash YYYY Name of Check Airman*Please enter the full name of the Check AirmanPassed at first attempt?*YesNoList down all the attempts for this checkride, starting from oldest to newest. The final attempt date needs to match the graduation date.1st Attempt Check Airman1st Attempt Date Date Format: MM slash DD slash YYYY 2nd Attempt Check Airman2nd Attempt Date Date Format: MM slash DD slash YYYY 3rd Attempt Check Airman3rd Attempt Date Date Format: MM slash DD slash YYYY 4th Attempt Check Airman4th Attempt Date Date Format: MM slash DD slash YYYY 5th Attempt Check Airman5th Attempt Date Date Format: MM slash DD slash YYYY Is this your last course at Phoenix East Aviation?*Select belowYesNoIf you're not sure or have not decided yet, select "No".What is your next course?*E.g. "141 Commercial ASEL" or "61 CFI Initial". Examiner should ask the student this question. If this course that you graduated from what the last course, please enter "N/A".Does the student have an LOA with a Foreign License?*YesNoIf yes, please scan it along with the rest of the paperwork.Extra Notes/CommentsIf the check airman has other notes/comments, please enter them here.SPAM PreventionPlease check the box to help us prevent spam submissions.