.

CAR66 AIRCRAFT MAINTENANCE LICENSE

APPLICATION FOR GCAA BASIC EXAMINATION & Re-SIT
(Please complete form in BLOCK CAPITAL)
1.

PERSONAL DETAILS

GCAA License/Licensing file number (if known)

Full Name (First,Middle,Last)
(Mr./Ms).....................
Date of Birth (dd/mm/yyyy).Place & Country of Birth......
Nationality.........Passport No.......
Permanent Address......
.....
Address for Correspondence...
.....
.....
Telephone Number..Mobile Number......
E-mail..Fax Number....
2.

EMPLOYERS DETAILS

Name and Address of Employer.....

.....................
.........
Telephone Number..P.O.Box..
Present Designation.....................................................................................................................................................................
Section.........................................
Date Joined :................................................................................................................................................................................
3. APPLICATION

Application for Examination:

In Category

Aeroplane Turbine

A1

B1.1

Aeroplane Piston

A2

B1.2

Helicopter Turbine

A3

B1.3

Helicopter Piston

A4

B1.4

Avionics

B2

Base Maintenance Certifying Engineer

Is this the first application for examination to GCAA:

Yes

No

Is the examination being taken for removal of limitations on existing license:

Yes

No

Is the examination being taken for addition of another category to existing license

AMEL FORM 01/ Rev 1

Issued October 2011

Yes

No

Page 1 of 4

Please select modules applied for through this application by selecting () the appropriate modules:
Module

Exam (MCQ)

Module

Exam(MCQ)

Mathematics

12

Helicopter Aerodynamics, Structures & Systems

Physics

13

Aircraft Aerodynamics, Structures & Systems

Electrical Fundamentals

14

Propulsion

Electronics Fundamentals

15

Gas Turbine Engine

Digital Techniques/Electronic

16

Piston Engine

Instrument systems

17

Propeller

Materials & Hardware

18

Air Legislation

Maintenance Practices

Basic Aerodynamics

Maintenance Practices

Human Factors

Human Factor

10

Aviation Legislation

10

Aviation Legislation

11

Aeroplane Aerodynamics, Structures

18

Air Legislation

Essays

& Systems

4.

EXAMINATION MODULES SUCCESSFULLY COMPLETED WITH GCAA (Please tick appropriate boxes)

None

Module

Exam (MCQ)

Module

Exam(MCQ)

Mathematics

12

Helicopter Aerodynamics, Structures & Systems

Physics

13

Aircraft Aerodynamics, Structures & Systems

Electrical Fundamentals

14

Propulsion

Electronics Fundamentals

15

Gas Turbine Engine

Digital Techniques/Electronic

16

Piston Engine

Instrument systems

17

Propeller

Materials & Hardware

18

Air Legislation

Maintenance Practices

Basic Aerodynamics

Maintenance Practices

Human Factors

Human Factor

10

Aviation Legislation

10

Aviation Legislation

11

Aeroplane Aerodynamics, Structures

18

Air Legislation

Essays

& Systems

AMEL FORM 01/Rev 1

Issued October 2011

Page 2 of 4

5.

DECLARATION

I hereby declare and certify all information that I have furnished on this form is true and correct to the best of my
knowledge and belief. I undertake that I have not taken examination in any of the modules applied in this application
within the last ninety (90) days. I understand any false or misleading statement may result in the refusal of this application
or revocation / suspension of the licence.

SIGNATURE OF APPLICANT: __________________________

6.

DATE: ________________
Day / Month / Year

QUALITY MANAGERS RECOMMENDATIONS

I confirm that __________________________________________________________________ is working in our

organization in the capacity of ______________________________________________________________________
and recommend his application for the examination applied for in Section 3 of this application.
Name...Position...............
Company.Approval number............
Telephone Number.E-mail..............
Signature.....Date.............

Stamp.........................................................................................................................................................
7. DOCUMENTs CHECKLIST ( For GCAA USE )
Candidate to ensure submission of the manuals/documents along with this application

Document

Submitted

Covering letter from employer

Copies of previous GCAA examination results ( as applicable )

One recent colour photograph with white background

(with initial application only)
Copy of Passport and valid Visa page

Applicable licensing fee

8.

Not Submitted

INSPECTOR REMARKS (For GCAA Use)

Recommended

Not Recommended

Inspector Name: ___________________________________________________________________________________

Signature: ____________________________________ Date:______________________________________________

AMEL FORM 01/Rev 1

Issued October 2011

Page 3 of 4

MANAGER ENGINEERING LICENSING REMARKS (For GCAA Use)

Approved

Name:

AMEL FORM 01/Rev 1

Issued October 2011

Not approved

Signature:

Date:

Page 4 of 4