Form No: CAA/PL/E/09
CIVIL AVIATION AUTHORITY OF SRI LANKA
Application for Aircraft Maintenance Licence Examination
1. PARTICULARS OF THE APPLICANT
1. Full Name
2. Surname
3. Date of birth (dd/mm/yyyy) ......................................................... Age ....
4. Nationality...................................................................................
5. NIC/Passport Number .........................................................................................................................................................................
..
6. Postal Address for correspondence........................................................................................................................................................
..
7. Telephone Number ....................................................................
8. E-mail..........................................................................................
Fax Number ..................................................................................
9. Present Employer Name/Address
10. Present Designation .
2.
LICENCE DETAILS
11. Dates of previous sittings :
Date
Category
Pass/Fail
12. Present Aircraft Maintenance Licence held
Licence No
Issuing Authority
Endorsements/Ratings/
Categories
Validity Period
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3.
CATEGORY / SUB- CATEGORY OF EXAMINATION (tick appropriate box(s))
Category
Aeroplanes Turbine
A1
B1.1
Aeroplanes Piston
A2
B1.2
Helicopter Turbine
A3
B1.3
Helicopter Piston
A4
B1.4
Avionic
4.
N/A
B2
EXAMINATION PAPERS (tick appropriate box(s) against the module(s) you wish to take at this examination)
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Module
1. Mathematics
CAA Use
only
Module
10. Aviation Legislation
11A. Turbine Aero plane
Aerodynamics,
Structures and Systems
2. Physics
3. Electrical Fundamentals
11B. Piston Aero plane
Aerodynamics,
Structures and Systems
4. Electronic Fundamentals
12. Helicopter Aerodynamics
Structures and Systems
5. Digital
Techniques/Electronic
Instrument Systems
13. Aircraft Aerodynamics
Structures and Systems
6. Materials and Hardware
14. Propulsion
7. Maintenance Practices
15. Gas Turbine Engine
8. Basic Aerodynamics
16. Piston Engine
9. Human Factors
17. Propeller
5.
CAA Use
only
EDUCATIONAL QUALIFICATIONS (attach certified copies of certificates)
Examination
6.
Year
Results (Subject/ Category)
TRAINING COURSES IN AIRCRAFT MAINTENANCE
(Attach copies of training course details and certificates, signed and certified placing the seal as true copy of the original by
Present Employer /Notary public/ Justice of peace. Attach extra papers if space is inadequate)
Name
Institute
Country
Period
From-To
Course Title
Results
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7.
EXPERIENCE IN AIRCRAFT MAINTENANCE
( *Attach copies of the worksheets /AM logbook certified by the Supervisor,
*Column 03 of the following table must be signed by a Manager of the Organization who provided the training or provides
employment , giving full name , designation and signature,
* Attach extra papers if space is inadequate)
(1)
Precise Nature
of work & Types
of Aircraft,
Engines or
Systems
(2)
Period
From
(3)
Certifying Officer
To
Name/Designatio
n
Organization
Signature
I hereby certify that the particulars furnished by me in this application form are true and accurate
to the best of my knowledge
I also certify that I am aware of the requirements and conditions applicable to the issue of an
Aircraft Maintenance Licence as specified by the DGCA and of the fact that my application will be
rejected if any of the particulars furnished above are found to be false or incorrect.
I have obtained a copy of ASN 083 & 097 & have read and understood its contents as it applies
to this application.
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_______________________
Signature of the Applicant
Date :________________
For official use only
Qualifies
Yes
No
Remarks
Signature of the
CAA Officer
Experience
Educational
Qualifications
Qualifies for
conversion
Fee paid
Application
Rejected
Applicant
Notified
Other details
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