gaca_gov_sa · form · processed · 3 chunks
GACA ال necesita العامه للطيران المدني General Authority of Civil Aviation [Non-Text] FOREIGN (TCI) ISSUANCE /RENEWAL APPLICATION FORM Flight Simulator - All instructor ratings and authorizations are valid for a period of 3 years FOR APPLICANT USE ONLY <table><tr><td colspan="4">1. Training Center Details</td></tr><tr><td>Training Center Name</td><td colspan="3"></td></tr><tr><td>Address</td><td colspan="3"></td></tr><tr><td>Airplane Type</td><td colspan="3"></td></tr><tr><td>Airplane Variant</td><td colspan="3"></td></tr><tr><td>Training Post Holder (Head of Training)</td><td>Name</td><td>Email</td><td>Phone No.</td></tr><tr><td>Contact Details</td><td></td><td></td><td></td></tr></table> <table><tr><td colspan="4">2. Personal information Details</td></tr><tr><td>Applicant Name</td><td colspan="3"></td></tr><tr><td>Address</td><td colspan="3"></td></tr><tr><td>Mobile Tel. No</td><td colspan="3"></td></tr><tr><td>Date &Place of Birth Variant</td><td></td><td>Nationality</td><td></td></tr><tr><td colspan="4">I hereby declare that the information given in this form is true, correct & completed</td></tr><tr><td>Applicant Signature</td><td colspan="3"></td></tr></table> <table><tr><td colspan="4">3. Application Details.</td></tr><tr><td colspan="2">Application for Training Center acceptance/ authorization</td><td>□ Issuance</td><td>□ Renewal</td></tr><tr><td>Airplane type details</td><td></td><td>Airplane variant details</td><td></td></tr></table> <table><tr><td colspan="4">4. Applicant License(s) and Instructor Rating Details</td></tr><tr><td>License Type and Number</td><td></td><td>License Expiry Date(if applicable) (dd/mm/yy)</td><td></td></tr><tr><td>Training Center Instructor Category</td><td></td><td>Instructor Rating Expiry Date(dd/mm/yy)</td><td></td></tr></table> <table><tr><td colspan="4">5. Foreign Training Instructor Acceptance Authorization Issuance/Renewal Requirements</td></tr><tr><td>Seq.</td><td>Requirements</td><td>YES</td><td>NO</td></tr><tr><td rowspan="3">a</td><td>Hold or has held Pilot License issued by ICAO Contracting State (Competent Authority), at least CPL. For ATPL training ATPL.</td><td>□</td><td>□</td></tr><tr><td>i) holds at least an equivalent license, rating, or certificate on the subject he is authorized to instruct.;</td><td>□</td><td>□</td></tr><tr><td>ii) holds a valid type rating for which he is authorized to instruct;</td><td>□</td><td>□</td></tr><tr><td rowspan="2">b</td><td>comply with the requirements established in GACAR-142 for the issuance of the relevant instructor certificate/authorization, or at least with ICAO Annex 1 requirements; and</td><td>□</td><td>□</td></tr><tr><td>i) demonstrates to GACA an adequate level of knowledge of the applicable GACA rules and regulations to be able to exercise instructional privileges in accordance with this Part.</td><td>□</td><td>□</td></tr><tr><td>c</td><td>Hold valid Instructor authorization/certificate in accordance with ICAO Contracting State (Competent Authority) requirements</td><td>□</td><td>□</td></tr><tr><td>d</td><td>Completed initial and recurrent training and checking requirements in accordance with the Competent Authority (ICAO Contracting State) or at least ICAO Annex 1 requirements</td><td>□</td><td>□</td></tr><tr><td>e</td><td>Completed Training Center Initial acceptance requirements, training and awareness about the applicable administrative procedures, contents of Training and Procedures Manual(s) Quality System as well as related documents, forms and records in accordance with Training Center Training and Procedures Operations Manual</td><td>□</td><td>□</td></tr><tr><td>f</td><td>Completed Instructor Standardization in accordance with Foreign Taring Center approved Instructor Standardization program</td><td>□</td><td>□</td></tr><tr><td>g</td><td>Conducted session of training related to the duties of Training Center Instructor (A) on the applicable type of airplane under GACA ASI/Designee Examiner supervision to meet GACA Standard</td><td>□</td><td>□</td></tr></table> GACA-AVSES-OPS-F032 Rev: 3, Date: 15 Jun 25 Page 1 of 2 GACA ال necesita للطيران المدني General Authority of Civil Aviation [Non-Text] FOREIGN (TCI) ISSUANCE /RENEWAL APPLICATION FORM <table><tr><td colspan="4">6. Head of Training Recommendation</td></tr><tr><td colspan="4">I hereby certify that the applicant meets GACA requirements for Foreign Training Center Instructor acceptance authorization issuance/renewal on( ) Type Rating, and I have checked the applicant license(s) (if applicable), logbook (if applicable) and records. I am satisfied that the information contained in this application is correct and so Applicant is recommended.</td></tr><tr><td>Training Post Holder Name</td><td></td><td>Date</td><td></td></tr><tr><td>Training Center Name</td><td></td><td>Signature</td><td></td></tr></table> <table><tr><td colspan="2">FOR GACA USE ONLY</td></tr><tr><td colspan="2">1. Evaluator/Examiner Designation</td></tr><tr><td colspan="2">The undersigned, on behalf of General Manager Flight Operations Department authorizes☐ ASI ☐ Designee ExaminerCapt.) ( ) Type Rating. to supervise and Evaluate Training Center Instructor on FSTD type ( ) ( ) Type Rating.</td></tr></table> <table><tr><td colspan="2">2. Evaluator/Examiner Recommendation (ASI notified by GACA)</td></tr><tr><td>Date</td><td>Departure/ Destination</td></tr><tr><td>Training Center Name</td><td>Landing time</td></tr><tr><td>FSTD Type & number</td><td>Total flight time</td></tr><tr><td>Take off time</td><td>Training Center Instructor Evaluation result □ Pass □ Fail</td></tr><tr><td colspan="2">GACA Inspector name</td></tr><tr><td colspan="2">Examiner recommendations</td></tr><tr><td>Aviation Safety Inspector Name</td><td>Signature Date</td></tr><tr><td></td><td></td></tr></table> <table><tr><td colspan="3">3. GACA Recommendation</td></tr><tr><td>Training Center Instructor issuance/renewal</td><td>□ Approved</td><td>□ Not Approved</td></tr><tr><td>Training Center Instructor privileges</td><td colspan="2"></td></tr><tr><td>Instructor rating details</td><td>Type rating expiry date</td><td></td></tr><tr><td>Training Center Instructor</td><td>Authorization expiry date</td><td></td></tr><tr><td>License type and number</td><td>License Expiry date</td><td></td></tr><tr><td>Training Center Instructor Rating Category</td><td>Training Center Instructor Expiry date</td><td></td></tr><tr><td colspan="3">Remarks</td></tr></table> <table><tr><td>Aviation Safety Inspector Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr></table> SUPPORTING DOCUMENTS • These application forms • Cover Letter from the Foreign Training Center for application, if required • Copy of Applicant License(s) (ICAO Contracting State) • Copy of Instructor Certificate/authorization (Component Authority (ICAO Contracting State)) • Copy of Foreign Training Center Instructor acceptance authorization (GACA authorization) for Renewal • Copy of last page of related Logbook Page or any documented evidence for instructing achievement within the last year • After conducting the Instructor Evaluation by GACA ASI/Designated Examiner: - These application forms - Training Instructor Evaluation/Test Report. GACA-AVSES-OPS-F032 Rev: 3, Date: 15 Jun 25 Page 2 of 2