HSI Competency Assessment

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document_type=form entity=format:application/pdf entity=language:ar language=en taxonomy_l1=transport taxonomy_l2=aviation taxonomy_l3=airport_operations validity=valid validity_confidence=0.6

GACA®
الهييه العامه للطيران المدني
General Authority of Civil Aviation
Competency Assessment Form for Heliport Management Personnel
(To be filled by Heliport Safety Inspector and Heliport Certification Project Manager)
<table><tr><td colspan="2">Name of Applicant</td><td colspan="2"></td><td>Name of Position</td><td colspan="2"></td></tr><tr><td colspan="2">Name of Airport</td><td colspan="2"></td><td>Date of Assessment</td><td colspan="2"></td></tr><tr><td colspan="7">Competency Assessment Results</td></tr><tr><td>No</td><td colspan="4">Competency Assessment Component</td><td>Possible Marks</td><td>Marks Obtained</td></tr><tr><td rowspan="2">1</td><td rowspan="2" colspan="4">Qualification</td><td rowspan="2">Mandatory</td><td>Check (X) one box</td></tr><tr><td>Yes □ No □</td></tr><tr><td>2</td><td colspan="4">Experience</td><td>10</td><td></td></tr><tr><td>3</td><td colspan="4">Training</td><td>10</td><td></td></tr><tr><td>4</td><td colspan="4">Written Test</td><td>50</td><td></td></tr><tr><td>5</td><td colspan="4">Personal Interview</td><td>30</td><td></td></tr><tr><td colspan="5">Total</td><td>100</td><td></td></tr><tr><td rowspan="4" colspan="2">Assessment Committee (Min 3 Member)</td><td colspan="3">Name:</td><td colspan="2">Sign:</td></tr><tr><td colspan="3">Name:</td><td colspan="2">Sign:</td></tr><tr><td colspan="3">Name:</td><td colspan="2">Sign:</td><td></td></tr><tr><td colspan="3">Name:</td><td colspan="2">Sign:</td><td></td></tr><tr><td colspan="7">Heliport Certification Project Manager Recommendation</td></tr><tr><td colspan="4">Assessment Results (Tick Mark √)</td><td colspan="3">Competency Assessment Outcomes Remarks, if any</td></tr><tr><td colspan="3">Accepted</td><td colspan="4"></td></tr><tr><td colspan="3">Accepted with Conditions</td><td colspan="4">Condition 1: ......Condition 2: ......</td></tr><tr><td colspan="3">Not Accepted</td><td colspan="4">Reason(s):</td></tr><tr><td colspan="7">Competency Assessment Validation</td></tr><tr><td colspan="4">Signature of Designated HCPM: ......Name: ......Date: ......</td><td colspan="3">Signature of Concerned Department Manager:......Name: ......Date: ......</td></tr></table>
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GACA_AVS_AGA_F-138-105_V4.0 (20-December-2021)
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