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GACA العربيه العاميه للطيران المدني General Authority of Civil Aviation CHIEF GROUND INSTRUCTORS' ACCEPTANCE APPLICATION FORM (GACAR PART-143) <table><tr><td colspan="4">A. FOR APPLICANT USE ONLY</td></tr><tr><td colspan="4">1. School/Organization information</td></tr><tr><td>a</td><td>Training Academy/School Name</td><td colspan="2"></td></tr><tr><td>b</td><td>Address</td><td></td><td></td></tr><tr><td>c</td><td>Contact Number</td><td></td><td></td></tr><tr><td>d</td><td>Email Address</td><td colspan="2"></td></tr><tr><td colspan="4"></td></tr><tr><td colspan="4">2. Applicant (Nominated Chief Instructors) information</td></tr><tr><td>a</td><td>Name</td><td colspan="2"></td></tr><tr><td>b</td><td>ID/Passport Number</td><td colspan="2"></td></tr><tr><td>c</td><td>License Type</td><td colspan="2"></td></tr><tr><td>d</td><td>License Number</td><td colspan="2"></td></tr><tr><td>e</td><td>License issuance</td><td colspan="2"></td></tr><tr><td>f</td><td>Medical Class</td><td colspan="2"></td></tr><tr><td>g</td><td>Contact Number</td><td colspan="2"></td></tr><tr><td>h</td><td>Email Address</td><td colspan="2"></td></tr><tr><td colspan="4"></td></tr><tr><td colspan="4">3. Applicant (Nominated Chief Instructors) Qualifications</td></tr><tr><td colspan="4">Qualifications Relevant to Post (e.g. License (s), type/class ratings, instructor rating(s), Diploma, etc.)</td></tr><tr><td>a</td><td colspan="3"></td></tr><tr><td>b</td><td colspan="3"></td></tr><tr><td>c</td><td colspan="3"></td></tr><tr><td>d</td><td colspan="3"></td></tr><tr><td>e</td><td colspan="3"></td></tr><tr><td>f</td><td colspan="3"></td></tr><tr><td>g</td><td colspan="3"></td></tr><tr><td colspan="4">4. Applicant (Nominated Chief Ground Instructors) Experience</td></tr><tr><td colspan="4">Work Experience Relevant to the Chief Instructors Post</td></tr><tr><td>a</td><td colspan="3"></td></tr><tr><td>b</td><td colspan="3"></td></tr><tr><td>c</td><td colspan="3"></td></tr><tr><td>d</td><td colspan="3"></td></tr><tr><td colspan="4">5. Pilot School/Organization Declaration</td></tr><tr><td colspan="4">a. Nominated Post Holder. I hereby declare that the information given in this form is true, correct and completed.</td></tr><tr><td colspan="2">Name</td><td>Signature</td><td>Date</td></tr><tr><td colspan="2"></td><td></td><td></td></tr><tr><td colspan="4">b. Accountable Manager. I hereby declare that the applicant is nominated for Chief Instructors Post</td></tr><tr><td colspan="2">Name</td><td>Signature</td><td>Date</td></tr><tr><td colspan="2"></td><td></td><td></td></tr></table> GACA-AVSES-OPS-F065 Rev: 4, Date: 01 Dec 25 Page 1 of 3 GACA ال necesita العامه للطيران المدني General Authority of Civil Aviation [Non-Text] CHIEF GROUND INSTRUCTORS' ACCEPTANCE APPLICATION FORM (GACAR PART-143) B. CHIEF INSTRUCTORS REQUIREMENTS <table><tr><td>No.</td><td>GACAR PART-141.51 Chief Instructor Qualifications.</td><td>YES</td><td>NO</td></tr><tr><td rowspan="5">1</td><td>To be eligible for designation as a chief ground instructor for a course of training, an applicant must meet the following requirements:</td><td></td><td></td></tr><tr><td>a. Hold an Aircraft Dispatcher certificate/license or Commercial Pilot certificate/license;</td><td>□</td><td>□</td></tr><tr><td>b. Hold a current ground instructor certificate/authorization approved by GACA;</td><td>□</td><td>□</td></tr><tr><td>c. Has an extensive experience in aviation theoretical knowledge instruction for Aircraft Dispatcher certificate/license or Pilots certificates/licenses with at least 3 years' experience as a ground instructor in Dispatcher/Pilot's Approved Training Organization;</td><td>□</td><td>□</td></tr><tr><td>d. Has completed the Dispatcher Instructor recurrent training requirements;</td><td>□</td><td>□</td></tr><tr><td rowspan="5">2</td><td colspan="3">Has extensive knowledge about the following:</td></tr><tr><td>a. Aircraft dispatcher certificate/license requirements in accordance of GACAR 65, GACAR 143, eBook V 9, and any other Applicable provisions of GACARs and eBook Volumes.</td><td>□</td><td>□</td></tr><tr><td>b. Aircraft dispatcher training curriculum and training programme;</td><td>□</td><td>□</td></tr><tr><td>c. Instructors and Examiners Standardization</td><td>□</td><td>□</td></tr><tr><td>d. Training and procedures manual, students' progress, remedial action, etc.</td><td>□</td><td>□</td></tr><tr><td rowspan="5">3</td><td colspan="3">Has a comprehensive knowledge about the following:</td></tr><tr><td>a. Applicable provisions of the Kingdom of Saudi Arabia (KSA) Aeronautical Information Publication (AIP);</td><td>□</td><td>□</td></tr><tr><td>b. Record keeping system</td><td>□</td><td>□</td></tr><tr><td>c. Training organization manuals (SMS, QMS, etc.)</td><td>□</td><td>□</td></tr><tr><td>d. The objectives and approved completion standards of the course for which the person seeks to obtain designation as chief instructor.</td><td>□</td><td>□</td></tr><tr><td></td><td>e. Possess a sound managerial capability</td><td>□</td><td>□</td></tr></table> GACA-AVSES-OPS-F065 Rev: 4, Date: 01 Dec 25 Page 2 of 3 GACA العربيه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] CHIEF GROUND INSTRUCTORS' ACCEPTANCE APPLICATION FORM (GACAR PART-143) <table><tr><td colspan="4">C. FOR GACA USE ONLY</td></tr><tr><td>1</td><td>Nominated Chief Ground Instructors Post</td><td>□ Accepted</td><td>□ Rejected</td></tr><tr><td>No.</td><td colspan="3">Remarks</td></tr><tr><td>1</td><td colspan="3"></td></tr><tr><td>2</td><td colspan="3"></td></tr><tr><td>3</td><td colspan="3"></td></tr><tr><td>4</td><td colspan="3"></td></tr><tr><td>5</td><td colspan="3"></td></tr><tr><td>6</td><td colspan="3"></td></tr><tr><td>7</td><td colspan="3"></td></tr><tr><td>8</td><td colspan="3"></td></tr><tr><td>9</td><td colspan="3"></td></tr><tr><td>10</td><td colspan="3"></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><tr><td></td><td></td><td></td></tr></table> <table><tr><td colspan="4">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>This application form</td><td>□</td><td>□</td></tr><tr><td>2</td><td>Training Academy/School nomination letter.</td><td>□</td><td>□</td></tr><tr><td>3</td><td>Copy of Applicant C.V;</td><td>□</td><td>□</td></tr><tr><td>4</td><td>Copy of applicant License(s)/Certificate(s), degree, training certificates, etc.</td><td>□</td><td>□</td></tr><tr><td>5</td><td>Prof of relevant experience</td><td>□</td><td>□</td></tr><tr><td>6</td><td>Copy of passport/ID</td><td>□</td><td>□</td></tr><tr><td>7</td><td>One personal photo</td><td>□</td><td>□</td></tr></table> GACA-AVSES-OPS-F065 Rev: 4, Date: 01 Dec 25 Page 3 of 3