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1

Eligibility
2

Personal
3

Health
4

Cover level
5

Submit

Application for Loss of Licence Cover

Eligibility Criteria:

Eligibility Criteria

I am a full financial member of AFAP

I hold a current Commercial Pilot Licence or higher

I derive my principal source of income from piloting activities

I hold a current Australian Class 1 Medical Certificate

I am aged less than 56 years

I am a full financial member of AFAP(Required)

I am a full financial member of AFAP

I hold a current Commercial Pilot Licence or higher(Required)

I hold a current Commercial Pilot Licence or higher

I derive my principal source of income from piloting activities(Required)

I derive my principal source of income from piloting activities

I hold a current Australian Class 1 Medical Certificate(Required)

I hold a current Australian Class 1 Medical Certificate

I am aged less than 56 years(Required)

I am aged less than 56 years

Proof of Citizenship / Residency(Required)

a) Proof of Australian citizenship (Australian passport/birth certificate or certificate of citizenship) OR,

b) if NOT an Australian citizen, overseas passport and proof of Australian residency

Title

Your Name(Required)

Given Name/s Surname

Preferred Name

AFAP Membership Number(Required)

Date Of Birth(Required)

Gender

If Other, please specify

Is your residential address in Australia?(Required)

Your Residential Address(Required)

Street Address Address Line 2 City ZIP / Postal Code

State(Required)

Country(Required)

Overseas Address

Overseas Address Country(Required)

Section B: Contact Details

Primary Email Address(Required)

Secondary Email Address

Mobile Number(Required)

Overseas Phone

Home Phone

Preferred Phone(Required)

Section C: Your Employment Details

Licence Type(Required)

Aviation Reference Number (ARN)(Required)

Welcome back. Do you want to?

Employer(Required)

Employee/ Staff Number

If General Aviation or Self Employed, provide details(Required)

Date Commenced(Required)

Type of Operation(Required)

Gross Base Annual Salary in $AUD(Required)

Section D: Australian Class 1 Medical Certificate

Date of your last Class 1 Medical Examination(Required)

Are you currently able to exercise the privileges of your Australian Class 1 Medical Certificate?(Required)

Yes

No

Do you currently have any restrictions on your Class 1 Medical Certificate?(Required)

Yes

No

If yes, please provide details:

Section E: Document Uploads

Upload Citizenship Proof(Required)

Drop files here or

Accepted file types: pdf, png, jpg, Max. file size: 300 MB.

Drop files here or

Upload most recent Payslip/employment contract here(Required)

Drop files here or

Accepted file types: pdf, png, jpg, Max. file size: 300 MB.

Drop files here or

Upload current Australian Class 1 Medical Certificate here(Required)

Drop files here or

Accepted file types: pdf, png, jpg, Max. file size: 300 MB.

Drop files here or

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The information on this website has been prepared by Austair Pilots Pty Ltd (ACN 005 111 731, AFSL 344259) as trustee of the Australian Air Pilots Mutual Benefit Fund (MBF).

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