EASA PART 66 APPROVED AIRCRAFT MAINTENANCE TRAINING APPLICATION
MALAYSIAN
INSTITUTE OF AVIATION
AERO路BILDUNGS
TECHNOLOGY
Month Year
Instructions: ~
GmbH
Please fill the application
~ Please tick
(--II where
in CAPITAL
LETTERS.
applicable.
SECTION 1: PROGRAMME PREFERENCE * CATEGORY B1
D(MECHANICAL)
DB
o o DB
CATEGORY B2
D
(AVIONICS)
1.1 : AEROPLANES TURBINE B 1.2 : AEROPLANE PISTON 1.3: HELICOPTER TURBINE B 1.4 : HELICOPTER PISTON
SECTION 2: PERSONAL DETAILS Full Name
ICorrespondence
Address
~ Postcode
1---------------------------State/Cou ntry IC/Passport No.
_________________
Contact No. Gender:
Nationality
--11 Mobile
c::J
DMaie
Race & Religion
No.
Female (For Malaysian only)
Age
Date of Birth
Marital Status Medical background:
Email Address Disability
SI;CTION 3: PARENT/GUARDIAN
Chronic Disease Code *
INFORMATION
Full Name
Note (*): Please refer to guidelines
Code *
Relationship
given.
Address
Contact No.
SECTION 4: QIJAUFICA. 10.. INFORMATION
D
SPM
SPMV
D
Subjects
O'Level
D
Year
Grade
Subjects
c::::J c::::J c::::J c::::J
1 2 3 4 FOR MALAYSIAN
APPLICANTS
6 7
8
1 ====~I
=====1 1......1
ONLY: SPM (July):
1
BAHASA MELAYU
5
MATHEMATICS
BAHASA INGGERISI"--_---J
1
_
OTHER QUALIFICATIONS Highest
Qualification
I Professional
Lisence
Major I Specialization University CGPA
WORKING
I Institute
D 路1""--_ EXPERIENCES*
Have you completed
your studies?
Yes
DNoC]
If applicable
Designation
Year
Company
From
Note (*): Five years prior to the applications
TI I declare that the information given herein are complete and correct and the document copies are true. I understand that my application can be rejected in the event that my submission are incorrect, incomplete or false. Applicant's
Date:
Signature:
2
To
CHECKLIST FOR APPLICANT The following
document
must be submitted
together
with application
form.
I ( \j
No Supporting document to be included Certified true copy of * SPM / SPMV / Q'Level Certficate 1
* STPM / A' Level Certificate
* Certficate / Diploma certificates 2
and
or with transcript/result
slip of every semester
Certification Letter of Completion of Studies from previous If applicants still waiting for final result.
3
A copy of NRIC and Birth Certificates
*
PLEASE SEND APPLICATION TO:
institutions,
EASA Program.
Malaysian Institute of Aviation Technology Lot 2891, Jalan Jenderam MALAYSIA. Fax: (603) 8768 7572/8485 Tel: (603) 8768 8487/7588
Hulu, Jenderam
Hulu, 43800, Dengkil, Selangor
Darul Ehsan.
)
GUIDELINES SECTION 1:
PROGRAMME PREFERENCE i) Programme offered by semester is subject to change
SECTION 2: MEDICAL BACKGROUND Physical Disability CODE
00 01 02 03 04 05 06 07 08
DESCRIPTION No disability Blind Deaf obe ear/both Dumb Leg-Disability Hand-Disability Lonq/Short Siqhted Colour Blind Others
Chronic Desease CODE DESCRIPTION 00 No Chronic Desease 01 Bladder Stone or Gall Stone, kolestisis 02 High Blood 03 Diabetes 04 Desease regarding blood/brain vessel Cataract, ptegrium 05 06 Tumor 07 Cancer Hernia, Fistulate, Hydrocale 08 09 Knee/Backbone problem 10 Endometriosis 11 Epilepsy 12 Gastric 13 Ulcer 14 Eritematocus 15 Prostate Glen Organ Disfunctional e.g Kidney 16 17 Mental illness 18 HIV 19 Others