Form 906 - Air Traffic Controller (Atc) Initial Licence/ Additional Rating & Exchange Application

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Form 906
Air Traffic Controller (ATC) Initial Licence/
Additional Rating & Exchange Application
Refer to: CASR Part 65
CASA Stamp:
IMPORTANT INFORMATION FOR APPLICANTS
1: This application form is for the purposes of an application for an initial Air Traffic Control (ATC) Licence, an application for
an ATC Licence Exchange (replacing Form 907) and an application for additional ATC rating(s) (replacing Form 908).
2: Payment for processing this application form can be made online. Go to the CASA webpage and click the Payment
button. You must attach a copy of the receipt with this application.
3: This form can be completed electronically and saved locally to your computer. Once the ARN has been entered on the
first page, it will automatically update in the applicant ARN fields on subsequent pages. CASA recommends that applicants
complete as much of the form electronically as possible.
4: Please ensure your application and the checklist are completed correctly and that all required supporting documentation
is provided. Incomplete applications will not be accepted and may be returned to you for amendment. Fields and sections
marked with an * are mandatory.
Applicant Details on Birth Certificate / Passport:
Applicant ARN:*
Title:*
__________________________________
Family Name:*
__________________________________
Given Names:*
__________________________________
Date of Birth:*
__________________________________
CONTACT DETAILS
Note: You are required to notify CASA of any changes to your personal contact information (refer to CASR 11.070).
Correspondence, including permissions issued as a result of this application, will be sent by post to the current postal
address according to CASA’s records.
You should notify CASA of any changes using one of the following methods:
• Log onto the CASA Self Service Portal
https://portal.casa.gov.au/selfservice/
Submit Online Change of Details form
https://portal.casa.gov.au/casaforms/addrchange.htm
Privacy Statement: Any personal information you provide to CASA is protected by the Privacy Act 1988 (Cth). CASA can
only collect, use and disclose that information in accordance with that Act. CASA will use the information collected in this
form for purposes associated with performing its functions under the Civil Aviation Act 1988, the Airspace Act 2007, the
Aviation Transport Security Act 2004 or the regulations made under those Acts. For full details on how CASA collects,
protects and uses personal information, please refer to
CASA’s Privacy
Policy.
Type of Application:*
ATC licence and initial rating(s)
Exchange Licence
Complete Section A1, A2, Section B, C and D
Complete Section A1, A3, Section C and D
Additional ATC rating(s)
Complete Section A1, A2, Section B, C and D
Section A: Qualification Details*
1. Medical Details
Class 3 Medical Certificate Date of Issue :
____ / ____ / ________
Class 3 Medical Certificate Date of Expiry :
____ / ____ / ________
2. Rating(s)
Mark appropriate box/boxes for ratings you are applying for.
Aerodrome Control
Approach Control
Approach Radar Control
Area Control
Area Radar Control
Form 906 09/2015
ATC Initial Licence/Additional Ratings & Exchange Application
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