CIVIL AVIATION AUTHORITY OF SRI LANKA
|Payments Made |
|Express Evaluation | |
|Normal Evaluation | |
CIVIL AVIATION AUTHORITY OF SRI LANKA
APPLICATION FOR THE RENEWAL OF ATC RATING
I. Rating to be renewed
|Aerodrome Control Rating |Aerodrome Control Rating |Approach Control Rating |Area Airways Rating |Approach Radar Rating |
|Katunayake |Ratmalana | | | |
(Tick appropriate box)
II. Personal Particulars:
1. Name in full: AAAA BBBBBBB XYZ ………………………………………….……………….
…………………………………………………….…………………………….……. (Block letters, Surname first)
2. Telephone No.: 011 2345689………. E-mail Address: aaaaaa@ …………………
III. Professional Particulars:
3. Licence No.: ATC/000 ……………………………………………..……………………………….
4. Date of expiry of licence: 15.07.2002 ……..………………………………………………………..
5. The last date of Medical Examination: 15.07.2002………………………..………………………
6. Date of expiry of ratings:
|Rating |Date of Expiry |
|Aerodrome Control Rating – a (i) |16.02.2002 |
|Aerodrome Control Rating – a (ii) |16.02.2002 |
|Approach Control Rating - b |16.02.2002 |
|Area/ Airways Rating - c |16.02.2002 |
|Approach Radar Rating - d |N/A |
7. Date of the Rating Renewal Test: 14.02.2002 ……………………..……………………………….
8. Rating Test results: (Attach result sheet) PASS……………………………………………………
9. Recent Experience
Exercise the privileges of the rating endorsed on the licence for a period of not less than 40 hrs within the 06 months period immediately preceding this application.
| | |
|Unit |Period |
|Aerodrome Control Rating - Katunayake |01.01.2001 to 31.12.2001 |
|Aerodrome Control Rating - Ratmalana |01.01.2001 to 31.12.2001 |
|Approach Control Rating |01.01.2001 to 31.12.2001 |
|Area Airways Rating |01.01.2001 to 31.12.2001 |
|Approach Radar Rating |N/A |
I hereby confirm that the above particulars given by me are true and correct.
……10.01.2002……… …………………………..
Date Signature of Applicant
I certify that the entries in 7-9 are correct.
………………………. …………………………………………..
Date Head of Air Navigation Services
………………………………….. …………………………
Delivery Date Delivery Time
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