Application For Issue Of Air Traffic Service Licence Or Prime Rating - Pel Civil Aviation Authority

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Application for Issue of Air Traffic Service
Licence or Prime Rating
Applicant’s Specimen Signature
A completed Fit and Proper Person Questionnaire, form
CAA 24FPP
or CAA 24FPPDEC, is required with this
application. Refer to the 24FPP form for guidance on the appropriate form to be used.
1. Personal Details
MCAA Client / Licence Number
Date of Birth
(if known)
(DD-MMM-YYYY)
Surname
Title
(Mr/Mrs/Ms/Miss )
Given Name(s)
Country of Birth
Nationality
Address for Service
-
A
pplicants have to provide an address for service in Mongolia (i.e. a physical address) and to promptly notify the
Director of any changes.
Tel
Mob
Fax
Email
Postal Address
(if different from Address for Service)
Tel
Mob
Fax
Email
2. Licence Applied For
Please tick
Flight Service Trainee Licence (FSTL)
Air Traffic Trainee Licence (ATTL)
appropriate box.
Flight Service Operator Licence (FSOL)
Air Traffic Controller Licence (ATCL)
3. Rating Applied For
Please tick
Air Traffic Service Instructor Rating (ATIR)
Air Traffic Service Examiner Rating
appropriate box.
(ATER)
CAA USE ONLY
Receipt No.
Receipt Date
W/R No.
CAA 24065/01
Page 1 of 2
Rev 1 : Feb 2016 (NZ Rev 9)

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