gaca_gov_sa · form · processed · 2 chunks
GACA الهميه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] APPLICATION FOR PILOT SCHOOL CERTIFICATION <table><tr><td colspan="2">Name of School</td><td colspan="2">Telephone No.</td><td colspan="2">Address of Principal Business Office</td></tr><tr><td colspan="2"></td><td colspan="2"></td><td colspan="2"></td></tr><tr><td colspan="3">Location of Main Operation Base</td><td colspan="3">Location of Satellite Bases(s)</td></tr><tr><td colspan="3"></td><td colspan="3"></td></tr><tr><td colspan="6">Application Is Hereby Made For</td></tr><tr><td>□</td><td colspan="5">Issuance of a Pilot School Certificate and associated Operations Specifications to conduct the training courses identified below, and for the approval of these courses (three copies of each course outline are attached); also, examining authority is requested for the courses appropriately checked.</td></tr><tr><td>□</td><td colspan="5">Renewal of a Pilot School Certificate and associated Operations Specifications currently numbered ____ which expires on ____</td></tr><tr><td>□</td><td colspan="5">without changes to the currently approved course outlines.</td></tr><tr><td>□</td><td colspan="5">with addition of course(s) identified below for which approval is requested (three copies of each course outline is attached), including request for examining authority for the course(s) appropriately checked;</td></tr><tr><td>□</td><td colspan="5">with deletion of course(s) identified below from the curriculum.</td></tr><tr><td>□</td><td colspan="5">Amending the current Pilot School Certificate and associated Operations Specifications numbered ____ which expires on ____</td></tr><tr><td>□</td><td colspan="5">by adding the course(s) identified below for which approval is requested (three copies of each course outline are attached), including request for examining authority where appropriately checked;</td></tr><tr><td>□</td><td colspan="5">for deletion of the course(s) identified below from the curriculum</td></tr><tr><td colspan="6">Chief Inspector</td></tr><tr><td colspan="6">List of Aircraft</td></tr><tr><td colspan="2">Make</td><td colspan="2">Model</td><td colspan="2">Registration Mark</td></tr><tr><td colspan="2"></td><td colspan="2"></td><td colspan="2"></td></tr><tr><td colspan="2"></td><td colspan="2"></td><td colspan="2"></td></tr><tr><td colspan="2"></td><td colspan="2">I (WE) certify that I am (we are) familiar with GACAR Part 5 &141 of the GACA, and, to the best of my (our) knowledge, believe that my (our) school meets the requirements for certification as prescribed therein.</td><td colspan="2"></td></tr><tr><td colspan="2">Signature</td><td colspan="4">Title</td></tr><tr><td colspan="2"></td><td colspan="4">ACCOUNTABLE EXECUTIVE(GACAR 5.25 a)</td></tr><tr><td colspan="2"></td><td colspan="4">MANAGEMENT REPRESENTATIVE SMS (GACAR 5.25 c)</td></tr><tr><td colspan="2"></td><td colspan="4">ACCOUNTABLE MANAGER GACAR 141.49(d)</td></tr><tr><td>Date</td><td colspan="5"></td></tr><tr><td colspan="6">FOR GACA USE ONLY</td></tr><tr><td colspan="6">□ Approved□ a Provisional Pilot School Certificate□ a Pilot School Certificate, either with associated Operations Specifications bearing the number shown above is issued effective and which expires on ____□ Renewal without amendments□ Renewal with amendments</td></tr><tr><td colspan="6">□ Disapproved</td></tr><tr><td colspan="2">Signature of Approving Official</td><td colspan="2">Title</td><td colspan="2">Date</td></tr><tr><td colspan="2"></td><td colspan="2"></td><td colspan="2"></td></tr></table> GACA-AVSES-OPS-F024 Rev: 3, Date: 13 Jul 25 Page 1 of 2 GACA ال necesita للطيران المدني General Authority of Civil Aviation [Non-Text] APPLICATION FOR PILOT SCHOOL CERTIFICATION INSTRUCTIONS TO THE APPLICANT Submit an original and one copy of this application, completed in full, along with the required number of attachments where specified on the face of this form, to the GACA SS&AT Office having jurisdiction over the area in which the school is located. Signatures on the application should be as follows: 1. Application from a corporation should be signed by the president or such other officers as authorized by the corporation by-laws to sign for the corporation and certified to by the corporate secretary attesting to the authority of the individuals to sign such a document; 2. Application from a company, club, or association should be signed by the president or such other officer or director as authorized by the organization's by-laws, and attested to by the secretary. IDENTIFICATION OF TRAINING COURSES (CONTINUED) <table><tr><td colspan="3">NOTE: Where examining authority for a course is desired, place and "X" in the box adjacent to the course identification. s</td></tr><tr><td>□</td><td>□</td><td></td></tr><tr><td>□</td><td>□</td><td></td></tr><tr><td>□</td><td>□</td><td></td></tr><tr><td>□</td><td>□</td><td></td></tr><tr><td>□□</td><td>□</td><td></td></tr><tr><td>□</td><td>□</td><td></td></tr><tr><td>□</td><td>□</td><td></td></tr><tr><td>□</td><td>□</td><td rowspan="2"></td></tr><tr><td>□</td><td>□</td></tr></table> THE FOLLOWING SPACE FOR GACA USE ONLY <table><tr><td colspan="2">Recommendations of Inspector(s)</td></tr><tr><td colspan="2"></td></tr><tr><td colspan="2"></td></tr><tr><td colspan="2"></td></tr><tr><td colspan="2"></td></tr><tr><td colspan="2"></td></tr></table> GACA-AVSES-OPS-F024 Rev: 3, Date: 13 Jul 25 Page 2 of 2