Scribd
Upload
1K views3 pages

Ca Form 19-11

The document is an application form for an individual to apply for the issue of a basic knowledge examination certificate from DGCA India. It requests personal details of the applicant, the category/sub-category of license being applied for, details of modules/papers passed in previous DGCA examinations, fee payment details, a declaration confirming the accuracy of the information, and a checklist of required supporting documents to include with the application. Completed applications should be mailed to the Central Examination Organisation office in New Delhi.

Uploaded by

Dharmendra Sumitra Upadhyay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
1K views3 pages

Ca Form 19-11

The document is an application form for an individual to apply for the issue of a basic knowledge examination certificate from DGCA India. It requests personal details of the applicant, the category/sub-category of license being applied for, details of modules/papers passed in previous DGCA examinations, fee payment details, a declaration confirming the accuracy of the information, and a checklist of required supporting documents to include with the application. Completed applications should be mailed to the Central Examination Organisation office in New Delhi.

Uploaded by

Dharmendra Sumitra Upadhyay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

CAR 66 ISSUE II R 1

Appendix V –Applications and Formats


CA FORM 19-11: Application for issue of basic knowledge examination certificate

APPLICATION FOR ISSUE OF BASIC KNOWLEDGE DGCA INDIA


EXAMINATION CERTIFICATE CA Form 19-11

Please complete the form in BLOCK CAPITALS using black or dark blue ink after reading the attached guidance notes. Fields
marked with an asterisk * are mandatory and must be completed in all cases. Use Date Format – DD-MM-YYYY

1. *PERSONAL DETAILS
CEO Computer No.

*Name in full

*Permanent address ……………………..…………………………………………………………………………………………………..

……………………………………………………………………………………………………………..PIN Code................................

*Address for Communication (if different from above) ……………………..…………

……………………..……………………………………………………………………………………… PIN Code................................

Applicant Contact Phone Number ………………………..................E-mail…….………………………………………..

Name of the Current Employer…………………………………………………………………………..

Contact Phone Number of Employer ……………………..................E-mail…….…………………………………………

2. *APPLICATION

I hereby request DGCA to issue of basic knowledge examination certificate as indicated and confirm
that the information contained in this form was correct at the time of application ( Specify the required
category / sub-category of basic knowledge certificate)

Category/Sub-category of License applied for A B

Mechanical

Avionic
3. *Details of basic modules/papers relevant to modules passed
Exam Session
Category/sub- Category/sub- Exam Session in
Module No. in which Module No.
category category which Passed
Passed

4 *FEE DEAILS:
Demand Draft/ Banker’s Cheque
Fees
No.
Name of Bank
Date of Issue

5.*DECLARATION

I hereby confirm that: i) I apply for issue of basic knowledge certificate as indicated and confirm that
the information contained in this form was correct at the time of application ii) I did not apply earlier
to the office of DGCA for issue of basic knowledge certificate and the request was not turned down.

PLACE SIGNATURE

DATE NAME
It is an offence to make, with intent to deceive, any false representations for the purpose of procuring
the grant, issue, renewal or variation of any certificate, licence, approval, permission or other
document. Persons doing so render themselves liable to administrative/legal actions as per Aircraft
Rules 1937. Further the licence is liable for revocation / cancellation / suspension or permanently
makes the person ineligible to have an Aircraft Maintenance Engineer’s Licence.
6.*DETAILS OF DOCUMENTS, PHOTOGRAPH AND FEE Enclosure Tick DGCA
ENCLOSURES No. Mark Remarks
Details of DGCA Examinations passed : I
Session Roll
Module No. and Paper
No. passed No.
3. Electrical Fundamentals I (3)
4. Electronic Fundamental I (4)
5.Digital Techniques/ Electronic instrument
I (5)
Systems
6. Materials & Hardware I (6)
7A. Maintenance Practices I (7A)
7B. Maintenance Practices I (7B)
8. Basic Aerodynamics I (8)

9A. Human Factors I (9A)


9B. Human Factors I (9B)
10. Aviation Legislation I (10)
11A.Turbine Engine Aeroplane
I (11A)
Aerodynamics, Structures and System
11B. Piston Engine Aeroplane
I (11B)
Aerodynamics, Structures and Systems
11C. Piston Engine Aeroplane
I (11C)
Aerodynamics, Structures and Systems
12. Helicopter Aerodynamics, Structures
I (12)
and Systems
13. Aircraft Aerodynamics, Structures and
I (13)
Systems
14. Propulsion I (14)
15. Gas Turbine Engine I (15)
16. Piston Engine I (16)
17A. Propeller I (17A)
17B. Propeller I (17B)

Please refer to current notification for details of fees required. All original documents submitted will be
returned through the self-addressed cover affixed with necessary postal stamp (for speed post).
Completed application should be posted along with the required documentation to the Central
Examination Organisation, O/o the Directorate General of Civil Aviation, East block II, R K Puram, New
Delhi 110066.
Notes: Having clear concise supporting data will CEO to issue licences more effectively and with less risk
of errors or rejections. CEO will not contact you for clarification of details on applications and therefore
it is most important that you have the correct information before applying.
Failure to submit a correctly completed application form and the required documentation will lead to
the rejection of your application and the fee will be utilized for processing the application.

You might also like