039-training-school-academy-initial-certification-application-form-143

gaca_gov_sa · form · processed · 2 chunks

GACA
الهييه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
TRAINING SCHOOL (ACADEMY) INITIAL CERTIFICATION APPLICATION FORM
1. APPLICANT DETAILS
<table><tr><td>Training School (Academy) Name</td><td colspan="3"></td></tr><tr><td>Address of Principal Business office</td><td colspan="3"></td></tr><tr><td>Address of Main Operations Base</td><td colspan="3"></td></tr><tr><td>TA Satellite address, if applicable</td><td colspan="3"></td></tr><tr><td>Current TA Certificate &amp; Operations Specifications number</td><td></td><td>Expiry Date</td><td></td></tr><tr><td rowspan="2">Head of Training Contact Details</td><td>Name</td><td>Phone Number</td><td>E-Mail</td></tr><tr><td></td><td></td><td></td></tr></table>
2. TRAINING COURSES DETAILS
<table><tr><td>No.</td><td>Course Title</td></tr><tr><td>1</td><td></td></tr><tr><td>2</td><td></td></tr><tr><td>3</td><td></td></tr><tr><td>4</td><td></td></tr><tr><td>5</td><td></td></tr><tr><td>6</td><td></td></tr><tr><td>7</td><td></td></tr><tr><td>8</td><td></td></tr><tr><td>9</td><td></td></tr><tr><td>10</td><td></td></tr></table>
3. MANAGEMENT STRUCTURE DETAILS
<table><tr><td>Post</td><td>Name</td><td>Phone No.</td><td>E-Mail</td></tr><tr><td>Accountable Manager</td><td></td><td></td><td></td></tr><tr><td>Head of Training</td><td></td><td></td><td></td></tr><tr><td>Quality Manager</td><td></td><td></td><td></td></tr><tr><td>Chief Instructor, if applicable</td><td></td><td></td><td></td></tr></table>
4. TRAINING STAFF DETAILS
<table><tr><td>Number of employed TA Instructors</td><td></td></tr><tr><td>Number of contracted TA Instructors</td><td></td></tr></table>
5. APPROVED TRAINING FACILITIES DETAILS
<table><tr><td colspan="4">(a) Flight Operations Accommodation</td></tr><tr><td>Type</td><td>Location</td><td>Size</td><td>Number</td></tr><tr><td>Briefing Room</td><td></td><td></td><td></td></tr><tr><td>Rest Room</td><td></td><td></td><td></td></tr><tr><td>Staff Office</td><td></td><td></td><td></td></tr><tr><td>Record Keeping</td><td></td><td></td><td></td></tr></table>
<table><tr><td colspan="4">(b) Theoretical Training Facilities</td></tr><tr><td>Type</td><td>Location</td><td>Size</td><td>Number</td></tr><tr><td>Classroom</td><td></td><td></td><td></td></tr></table>
GACA-AVSES-OPS-F039
Rev: 3, Date: 15 Jun 25
Page 1 of 3

GACA
الهييه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
TRAINING SCHOOL (ACADEMY) INITIAL CERTIFICATION APPLICATION FORM
<table><tr><td>CBT Room</td><td></td><td></td><td></td></tr><tr><td>Rest Room</td><td></td><td></td><td></td></tr><tr><td>Staff Office</td><td></td><td></td><td></td></tr><tr><td>Record Keeping</td><td></td><td></td><td></td></tr></table>
6. FINANCIAL DETAILS
<table><tr><td>Financial Requirements</td></tr><tr><td>GACA Economic Authority</td></tr></table>
7. ACCOUNTABLE MANAGER DECLARATION
- I hereby apply for (XXX) Training School Certificate renewal in accordance with GACAR PART 143 and other applicable GAGARs and EBOOK Volumes requirements.
- The minimum qualification requirements for each management position are incompliance with GACA requirements.
• (XXX) Training School acknowledged that any change made in the assignment of persons in the required management positions must be notified the President within 10 working days.
• (XXX) Training School Management and Personnel are committed to maintain continuous compliance with GACAR PART 143 and all other applicable GACA requirements.
• I certify that the information contained in this application is true, corrected and completed.
<table><tr><td>Accountable Manager Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr></table>
A. GACA APPROVAL (GACA USE ONLY)
<table><tr><td colspan="3">1. GACA Assessment.</td></tr><tr><td colspan="3">Training School (TA) approval/certificate will be renewed in accordance with GACAR PART 143 and the other applicable GACARs and EBOOK Volumes.</td></tr><tr><td>Application form and all Supporting Documents Assessment Status</td><td>□ Accepted</td><td>□ Rejected</td></tr><tr><td>Applicant, (Training School), has satisfactorily completed all applicable GACA requirements, process</td><td>□ Yes</td><td>□ No</td></tr><tr><td>and procedures for Certificate/Approval Renewal</td><td>□ Approved</td><td>□ Rejected</td></tr></table>
2. Remarks
<table><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td>-</td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr></table>
GACA-AVSES-OPS-F039
Rev: 3, Date: 15 Jun 25
Page 2 of 3

GACA
الهميه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
TRAINING SCHOOL (ACADEMY) INITIAL CERTIFICATION APPLICATION FORM
<table><tr><td colspan="2">3. Approval Details</td></tr><tr><td>Training School (TA) Name</td><td></td></tr><tr><td>Certificate/Approval and Operations Specifications Expiry Date</td><td></td></tr><tr><td>Others, if applicable</td><td></td></tr></table>
<table><tr><td colspan="2">4. Certificate/Approval Restriction or limitations, if applicable</td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr><tr><td></td><td></td></tr></table>
<table><tr><td>Aviation Safety Inspector (ASI) Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr><tr><td>Training School Program Manager(TA Principal Inspector) Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr></table>
<table><tr><td colspan="4">5. Application Form Attachments and supporting Documents</td></tr><tr><td>No.</td><td>Supporting Documents</td><td>YES</td><td>NO</td></tr><tr><td>1</td><td>Copy of the Letter of Intent</td><td>□</td><td>□</td></tr><tr><td>2</td><td>GACA Economic Approval</td><td>□</td><td>□</td></tr><tr><td>3</td><td>Copy of Certificate/Approval fees slip</td><td>□</td><td>□</td></tr><tr><td>4</td><td>Management Approval/Acceptance Form (attached with relevant evidence)</td><td>□</td><td>□</td></tr><tr><td>5</td><td>Head of Training</td><td>□</td><td>□</td></tr><tr><td>6</td><td>Chief Instructor, if applicable</td><td>□</td><td>□</td></tr><tr><td>7</td><td>Quality Manager</td><td>□</td><td>□</td></tr><tr><td>8</td><td>Manuals Approval/Acceptance Forms &amp; Compliance Checklists</td><td>□</td><td>□</td></tr><tr><td>9</td><td>Operations Manual</td><td>□</td><td>□</td></tr><tr><td>10</td><td>Training Manual</td><td>□</td><td>□</td></tr></table>
GACA-AVSES-OPS-F039
Rev: 3, Date: 15 Jun 25
Page 3 of 3