CIVIL AVIATION AUTHORITY OF SRI LANKA
CIVIL AVIATION AUTHORITY OF SRI LANKA
APPLICATION FOR THE ISSUANCE OF ATC LICENCE
I. Personal Particulars
1. Name in full: Mr./ Ms. EEEEEEEEE, XXXXX, XXXXXX …………………………..……...
……………………………………………………….………………………..…………
(Block letters, Surname first)
2. Permanent Address: 001, Main Street, Colombo 01. …………………………………..……………
………………………………………………………………..……..……………
3. Sex : Male/ Female …………………………………………………………..…..…………………
4. Date of Birth: 01.10.2011 ……………………………………………………………………………
5. Telephone No: 011 2345678 ………………… E-mail Address: aaa@ abc. ……………
II. Professional Particulars
6. Date of appointment: 01.01.2011 ………….…………………………………………………..…….
7. Date of Medical Examination: 01.01.2011 …….…….……………………………………………...
III. Training Details
8. Theoretical Course
|Title of the course/ Details of the course |Country/ venue |Date of commencement |Date of completion |
| | | | |
|(Name of the Course) |(Name of country course |01.01.2011 |31.12.2011 |
| |followed ) | | |
| | | | |
9. On-the-job Training
|OJT training & Name of the instructors |OJT centre |Date of commencement |Date of completion |
| | | | |
|Mr. A B C xyz |Ratmalana |01.01.2012 |31.03.2012 |
| | | | |
| | | | |
10. Date of the Rating Assessment Test: 01.04.2012 ………………….……………………………….
11. Rating Test results: Pass ……………………………………………………………………………
12. Attached following documents:
I. certified copy of the course completion certificate
II. Details of the training course (Subjects followed, venue , duration)
III. OJT Assessment Report
IV. Rating Assessment Results
V. Letter of appointment from AASL
I received Pamphlet No. PL/P/07.
I hereby confirm that the above particulars given by me are true and correct.
……… 16.05.2009 …. …………………………..
Date Signature of Applicant
I certify that entries in 8-11 are correct.
……… 16.05.2009 ……. …………………………..
Date Head of Air Navigation Services
………………………………….. …………………………
Delivery Date Delivery Time
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