RLS Placement Request

Section 1Contact and Job Information

Who you are and the job you have now.

First Name *

Last Name *

Email Address *

Phone Number *

Residential City *

Residential State *

Residential state (other) *

Current/Most Recent Sector *

Agriculture Business/Corporate/VIP Transport Charter/Transport (Passenger/Cargo) Firefighting HEMS/Air Ambulance Law Enforcement/Police Military/Defense Off-Shore Surveying/Aerial Imaging Tourism/Leisure Charter/Sightseeing Training/Flight School Utility/External Load Other

Current/Most Recent Sector (other) *

Current/Most Recent Position *

Check Airman Chief Pilot Co-Pilot Instructor Line Pilot Pilot in Command Safety Officer Other

Current/Most Recent Position (other) *

Contact/Current Job Notes

Specific career coach?

Yes No

Career Coach Name *

Section 2Next Job Preferences

The move you want next.

Maximum Distance from Residence (miles) *

Preferred City

Preferred State

Preferred state (other)

Preferred Sector *

HEMS Off-Shore Utility

Preferred Position

Check Airman Chief Pilot EMS - Fixed Location EMS - Float Instructor Line Pilot Pilot in Command Safety Officer

Preferred Job Type

Full-time Part-time Seasonal Temporary

Require minimum salary? *

Yes No It Depends

Minimum salary *

What does this depend on?

Location based adjustment?

Yes No

What location-based adjustment do you require?

Require min signing bonus? *

Yes No It Depends

Minimum signing bonus *

What does this depend on?

Require min retention bonus? *

Yes No It Depends

Minimum retention bonus *

What does this depend on?

Require housing? *

Yes No It Depends

What does this depend on?

Housing

On Duty Housing Off Duty Housing

Require min stipend? *

Yes No It Depends

What does this depend on?

Minimum stipend amount *

What the stipend should cover

Compensation for High-Risk and High-Stress Work Support for Specialized Training and Certifications Offsetting Relocation or Commuting Costs Supplementing Healthcare or Wellness Needs Covering Equipment or Uniform Costs Supporting Part-Time or Dual Roles

Require min paid travel? *

Yes No It Depends

What does this depend on?

Paid travel

Travel Time Pay for Commuting to Remote Bases Reimbursement for Relocation or Temporary Housing Paid Travel for Training or Recurrent Certification Compensation for Travel Between Job Sites During Shifts Paid Travel for Emergency Call-Ins or Special Assignments Travel Benefits for Family Visits During Extended Assignments

Require any benefits?

Yes No

Benefits *

401k/403b AD&D Insurance Business Travel Accident Ins. Caregiver Time Child Care Assistance Continuing Education Allowance Cancer Insurance Dental Insurance Disability Insurance (Short-Term) Disability Insurance (Long-Term) Employee Assistance Program Employee Wellness Programs FSA/HSA Health Insurance Housing Life Insurance Long Term Care Insurance Maternity/Paternity Leave Mental Health services (FREE) Pet Insurance Prescription Drug Insurance PTO Relocation Assistance Tuition Reimbursement UpSkilling/ReSkilling Programs Vision Insurance Voluntary Legal

Shift Preference(s) *

5 on / 2 off 7 on / 7 off (12 hour shifts) 12 on / 2 off 14 on / 14 off 21 on / 21 off

Availability *

ASAP 1 - 2 weeks 3 - 4 weeks 1 - 2 months 2 months +

Preference Notes

Section 3Experience

Recent category time and hours. Every flight-time box is required.

How recently flown in category? *

Previous 12 Months Previous 24 Months

Add hours in specific aircraft?

Yes No

Aircraft hours

Check an aircraft, then enter hours.

A109 (AW109)

Hours in A109 (AW109)

AS332 (Eurocopter, Super Puma, Airbus H215)

Hours in AS332 (Eurocopter, Super Puma, Airbus H215)

AS350 (AStar, Airbus H125)

Hours in AS350 (AStar, Airbus H125)

AW101 (AgustaWestland, EH101, Merlin)

Hours in AW101 (AgustaWestland, EH101, Merlin)

AW119 (Koala)

Hours in AW119 (Koala)

AW139

Hours in AW139

AW169

Hours in AW169

AW189

Hours in AW189

Bell 206 (JetRanger, LongRanger)

Hours in Bell 206 (JetRanger, LongRanger)

Bell 222

Hours in Bell 222

Bell 230

Hours in Bell 230

Bell 407

Hours in Bell 407

Bell 412

Hours in Bell 412

Bell 427

Hours in Bell 427

Bell 429 (GlobalRanger)

Hours in Bell 429 (GlobalRanger)

Bell 430

Hours in Bell 430

B525 (Bell, Relentless)

Hours in B525 (Bell, Relentless)

CH-47 (Boeing, Chinook)

Hours in CH-47 (Boeing, Chinook)

EC130 (Airbus H130, T2)

Hours in EC130 (Airbus H130, T2)

EC135 (Airbus H135)

Hours in EC135 (Airbus H135)

EC145 (Airbus H145)

Hours in EC145 (Airbus H145)

H155 (Airbus, AS365, Dauphin)

Hours in H155 (Airbus, AS365, Dauphin)

H160 (Airbus)

Hours in H160 (Airbus)

H175 (Airbus, Eurocopter EC175, Avicopter AC352)

Hours in H175 (Airbus, Eurocopter EC175, Avicopter AC352)

H225 (Airbus, Super Puma)

Hours in H225 (Airbus, Super Puma)

MD 900 (Explorer)

Hours in MD 900 (Explorer)

MD 902 (Explorer)

Hours in MD 902 (Explorer)

NH90 (NH Industries, Tactical Transport Helicopter, NATO Frigate Helicopter)

Hours in NH90 (NH Industries, Tactical Transport Helicopter, NATO Frigate Helicopter)

S-61 (Sikorsky, Sea King)

Hours in S-61 (Sikorsky, Sea King)

S-64 (Sikorsky, Sky Crane)

Hours in S-64 (Sikorsky, Sky Crane)

S-70 (Sikorsky, UH-60, Black Hawk)

Hours in S-70 (Sikorsky, UH-60, Black Hawk)

S-76 (Sikorsky)

Hours in S-76 (Sikorsky)

S-92 (Sikorsky)

Hours in S-92 (Sikorsky)

UH-1 (Huey, Bell 205)

Hours in UH-1 (Huey, Bell 205)

UH-1N (Twin Huey, Bell)

Hours in UH-1N (Twin Huey, Bell)

Flight Times

Total *

Rotor *

PIC *

Turbine *

Unaided / Night *

NVG *

IFR (Actual or Simulated in Flight) *

Flight Time Notes

Section 4Qualifications

Graduation, certificates, type ratings, and cards.

Highest graduation *

High School/GED Technical/Vocational School (Certificate) Community School (Associates Degree) College/University (Bachelors Degree)

Current Certs *

ATP (Airline Transport Pilot) Rating Commercial Pilot License (Helicopter) Hoist Operator Certification HUET Instructor CFI/CFII Instrument Rating (Helicopter) Medical (First Class) Medical (Second Class) Vertical Reference Training

Type rated?

Yes No

Type ratings

A109 (AW109) AS332 (Eurocopter, Super Puma, Airbus H215) AW101 (AgustaWestland, EH101, Merlin) AW139 AW169 AW189 Bell 205 Bell 206 (JetRanger, LongRanger) Bell 212 Bell 214ST Bell 412 Bell 427 Bell 430 Bell 525 (Relentless) CH-47 (Boeing, Chinook) EC135 (Airbus H135) EC145 (Airbus H145) H155 (Airbus, AS365, Dauphin) H160 (Airbus) H175 (Airbus, Eurocopter EC175, Avicopter AC352) H225 (Airbus, Super Puma) MD500 (MD Helicopters, Hughes 500) NH90 (NHIndustries) S-61 (Sikorsky, Sea King) S-64 (Sikorsky, Sky Crane) S-70 (Sikorsky, UH-60 Black Hawk) S-76 (Sikorsky) S-92 (Sikorsky) UH-1N (Twin Huey, Bell)

Carded with agencies?

Yes No

Agencies

BLM (Bureau of Land Management) CAL FIRE (California Department of Forestry and Fire Protection) DoD (Department of Defense) NIFC (National Interagency Fire Center) NPS (National Park Service) USFWS (U.S. Fish and Wildlife Service) USFS (U.S. Forest Service)

USFS-carded aircraft *

A109 (AW109) AS350 (AStar, Airbus H125) Bell 204 (Huey) Bell 205 (Huey) Bell 206 (JetRanger, LongRanger) Bell 212 Bell 407 Bell 412 EC135 (Airbus H135) EC145 (Airbus H145) MD 500E MD 520N MD 530F S-76 (Sikorsky) UH-1 (Huey, Bell 205) UH-1N (Twin Huey, Bell)

Qualifications Notes

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Tell us the move you want.

Section 1Contact and Job Information

Section 2Next Job Preferences

Section 3Experience

Section 4Qualifications