Application For Air Traffic Controllers - Kiwa Page 2
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Rating / Rating endorsement / Licence endorsement(s)
Licence endorsement(s)
Language proficiency
OJTI
STDI
Assessor
endorsement (LPE)
Level 4
Level 5
Level 6
5
Unit endorsement revalidation / renewal
The applicant meets the requirements according to (EU) Nr. 2015/340 ATCO.B.020. The unit/licence
endorsement(s) annotated below are revalidated/renewed*. Based on this, revalidation/renewal* can be done
as listed below. (* Delete as appropiate)
Unit endorsement:
Valid until:
Unit endorsement:
Valid until:
Unit endorsement:
Valid until:
Unit endorsement:
Valid until:
Unit endorsement:
Valid until:
Unit endorsement:
Valid until:
I certify that the data is
Name:
Licence number assessor:
Signature:
complete and true.
Authorised assessor
6
Certificates / Documents
In order to assess your application, Kiwa Register requires you to attach the following documents (if
relevant) to the application form. Select the documents that accompany your application.
6.1
Issue of a licence
Copy of medical certificate
Copy of passport or identity card
Original Student ATCO licence (if applicable)
Copy of relevant training certificate/documents proving the successful completion of:
Initial training (integrated)
Basic training
Rating training
Unit training
Practical instructor training
Assessor training
Copy of language proficiency certificate
Copy of form “Declaration for temporary permission to act as (student) air traffic controller”
6.2
The issue of a language proficieny
Copy of medical certificate
endorsement LPE
Copy of language proficiency certificate
6.3
Revalidation of an unit endorsement
Copy of medical certificate
Copy of the ATCO unit endorsement revalidation form
Copy of the competence assessment form
Copy of form “Declaration for temporary permission to act as (student) air traffic controller”
6.4
Revalidation of an OJTI/STDI/
Copy of medical certificate
Assessor licence endorsement
Copy of refresher training certificate/document proving the successful completion of the training
6.5
Renewal of a unit endorsement
Copy of medical certificate
Copy of an assessment form of training undertaken in accordance with ATCO.B.020 and ATCO.D.060
Copy of form “Declaration for temporary permission to act as (student) air traffic controller”
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