Form No: 1317 - Air Traffic Controller Licence - State Of Kuwait Directorate General Of Civil Aviation

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P.O. Box 17, Safat 13001, Kuwait
State of Kuwait
Tel. (965) 2474-3940
Fax (965) 2476-5796
Directorate General of Civil Aviation
SITA: KWIASYA
Email: safety@dgca.gov.kw
Aviation Safety Department
Air Traffic Controller Licence
Notes: i)
Read the form thoroughly and complete the appropriate sections only.
ii) Complete the form in BLOCK CAPITALS or tick boxes
unless otherwise indicated
SECTION 1) APPLICATION FOR
(Complete Sections Listed)
Grant of an Air Traffic Controller Licence, Rating, Rating Endorsement, Unit Endorsement or English Language
Proficiency Endorsement (Sections 1, 2, 3, 4, 5, 7 and 8)
Air Traffic Controller Licence – expiry or withdrawal of an Unit Endorsement (Sections 1, 2, 6 and 7)
Change of Personal Details (Sections 1, 2 and 7)
SECTION 2) PERSONAL DETAILS
ATC Licence Number (if held)
Male
Female
Title:
………………………………
Surname: .....................................................................................
Forename(s)
...................................................................................
Date of Birth (dd/mm/yyyy): .........................................................
Nationality
.......................................................................................
Place of Birth: ..............................................................................
Country of Birth:
............................................................................
Permanent Address:
...........................................................................................................................................................................
...........................................................................................................................................................................
............................................................................................................................................................................
Country: ............................................. Postcode:..................................
Postal Address:
...........................................................................................................................................................................
(normally unit address)
...........................................................................................................................................................................
..........................................................................................................................................................................
Country: ............................................. Postcode:..................................
Telephone Numbers:
Home:
................................................................................................................................................................
(incl. area code)
Office:
................................................................................................................................................................
SECTION 3) UNIT ENDORSEMENT APPLIED FOR:
Proposed date (dd/mm/yyyy): …………………………………….
Location of examination: .....................................................................
Note: This information MUST be included
Unit Endorsement
Rating
Rating Endorsement
Description
ADV Aerodrome Control Visual
ADI Aerodrome Control Instrument
TWR
Tower Control
AIR
Air Control
RAD
Aerodrome Radar
GMC
Ground Movement Control
GMS
Ground Movement Surveillance
Form No: 1317
Page 1 of 4
28 April 2016 v0.1

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