Form 19E
ANO (AW)PART-66 AIRCRAFT MAINTENANCE ENGINEER’S LICENSE – APPLICATION FOR WRITTEN EXAMINATIN
1. APPLICANT INFORMATION
Name ……………………………………..………..................................................................................................... ............
Nationality: …………………………………… Date & Place of Birth …………………………………………………
National ID or PP Number: ………………………………………………..………………………………………………..
Permanent Address:……………………………………………………………………………………………..………......
City: ………………………………… Postcode: …………..…………..….. Country:……………………………….
Present Address: ……………………………………………………………………………….…………………….…..
City: ………………………………… Postcode: …………..…………..….. Country:……………………………….
Telephone Number ………………………..……….…. Mobile phone Number ………………………………………......
E-mail ………………………………………………. ………………………………..…………………….
Name and Address of Employer (if applicable):.…………………………….………………………………………......
……………………………………………………………………………….……………….. Postcode…………………
E-mail: …………………………………. …………………. Telephone Number........ ………………….………………
2. CATEGORY/SUB-CATEGORY OF EXAMINATION (CIRCLE AS APPROPRIATE)
Aeroplane Turbine A1 B1.1
Aeroplane Piston A2 B1.2
Helicopter Turbine A3 B1.3
Helicopter Piston A4 B1.4
Avionics B2
3. EXAMINATION MODULES WHICH YOU WISH TO TAKE (tick as appropriate)
MCQ
1. Mathematic 10. Aviation Legislation:
Essay
Turbine Aeroplane Aerodynamics,
2. Physics 11A.
Structures and Systems
Piston Aeroplane Aerodynamics,
3. Electrical Fundamentals 11B.
Structures and Systems
Helicopter Aerodynamics, Structures and
4. Electronic Fundamentals 12.
Systems
Digital Techniques/ Electronic Instrument Aircraft Aerodynamics, Structures and
5. 13.
Systems Systems
6. Materials and Hardware 14. Propulsion
MCQ
7. Maintenance practices 15 Gas Turbine Engine
Essay
8. Basic Aerodynamics 16. Piston Engine
MCQ
9. Human Factors 17. Propeller
Essay
Part Modules (if any)…..……………………………………………………………………………………………………
…………………………………..……………………………………………………………………………………………
Issue 1 Page 1 August 2016
Form 19E
4. ADDITIONAL INFORMATION
I am applying to take examinations for initial PART-66 Licence
I am applying to take examinations to remove limitations from my PART-66 Licence
I hold a PART-66 licence in a different category to the examination for which I am applying
Copy of Certificates/documents to be attached
Educational Certificate as per Part-66.A.15 National ID/Passport Evidence of failed module(s)
5. PAYMENT DETAILS
Examination fee of Taka:….……………………………… In words: …………………………………………………… .
Bank details:………………………………………………………………………………………………………………..
Receipt No: ………………………………………… Date: ……………………………………………………………….
6. DECLARATION ( see Guidance Notes )
I declare that the information on this form is correct.
I declare that I have not taken the above module examination(s) within the last 90 days.
I have undertaken a course of retraining and have enclosed the course completion certificate to allow me to re-take
the relevant modules in accordance with Part-66.
Name (block capitals) ..................................................................................Signature .......... ..............................
Date ...............................................
7. OFFICIAL USE:
Application accepted not accepted. Signature & Date :……………………………………….
Name:…………………………………..….…………..
Forwarded to examination manger/cell
Notify to candidate in writing (e-mail/letter)
Issue 1 Page 2 August 2016
Form 19E
General Guidance on how to complete PART-66 Licence – Application for Written Examination
1) Use this form to apply to sit any PART-66 written modular exams.
2) You should read the requirements of PART-66 before completing this form. PART-66 regulation requirement
is available on CAAB’s website www.caab.gov.bd
3) Examinations booking cannot be amended within 30 working days before the examination. Cancellations will
only be accepted if received in writing at least 30 working days before the examination. Refund of examination
fees may only be given if cancellation is received within 30 working days before the examination.
Please note failure to submit a correctly completed application form and the required documentation will
lead to the rejection of your application.
Section(s) 1 – Applicant Information
To be completed in all cases
Section 2 - Category
Dependent on the type of licence the applicant will be applying for in the future.
Section 3 - Examination Modules
To be completed single or more modules applicable for the category mentioned in section 2.
Section 4- Additional Information
Must clearly indicate the reason to take examination.
You must enclose a copy of your passport (or National ID card for Bangaldeshi) and certificate of educational
qualification as per Part-66.A.15. This must be certified as a true copy by the Quality Manager or senior person in
the Quality Department of your current employer or the Training Manager of the PART–147 Approved
Organisation as appropriate.
Section 5 - Charges
This application will not be processed until the applicable charges have been received
Section 6 - Declaration
PART-66, Appendix II, 1.11 states “All PART-66 modules that make up a complete PART-66 aircraft
maintenance licence category or sub category must be passed within a 5 year time period of passing the first
module except in the case specified in paragraph 1.12. A failed module may not be re-taken for at least 90 days
following the date of the failed module examination, except in the case of a PART-147 approved maintenance
training organisation which conducts a course of retraining tailored to the failed subjects in the particular module
when the failed module may be re-taken after 30 days”.
Applicants wishing to re-take any failed modules within 90 days must provide a course completion certificate
detailing:-
• the training establishments name and address
• the applicants (your) name
• details of the training given relating to the failed modules
• duration and dates of training
• a signature by appropriately authorised training personnel
By signing the declaration you are confirming that all of the information is correct and true.
Issue 1 Page 3 August 2016
