Consent To Email
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1Form 266
Consent to Email
I, ______________________________________
ARN:
(print name in full),
Date of Birth: ____ / ____ / _____ :
1. confirm that I have updated my email address through the CASA Self-service portal.
(Note: Address details are not updated from your Aviation Medical Application)
2. confirm I am responsible for the correctness of, and maintenance of, my email address.
3. hereby consent to all correspondence from the Aviation Medicine Branch of CASA being
sent to my email address.
Signed:
………………………………………………………………
Name:
___________________________________________
Date:
____ /____ /20____
Please submit this form by email to AvMed@casa.gov.au.
Form 266 10/2013
Consent to Email
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