RECRUITMENT OF STUDENT
AIR TRAFFIC CONTROLLERS
FOR ADMISSION TO THE INITIAL SELECTION PROCEDURE
Confidential
Please complete all relevant fields. Answer each question clearly
and completely in English. Any incomplete / missing answers will result in the application being returned to you.
All details given will be treated in confidence.
1. SURNAME
MAIDEN NAME (IF APPLICABLE)
2. ADDRESS
FORENAME
EMAIL
Tel. Work
Tel. Home
Mobile Tel.
3. PLACE OF BIRTH
4.
COMPLETED
DATE OF BIRTH (DD/MM/YY)
MILITARY SERVICE
NOT COMPLETED
PRESENT NATIONALITY (IF DUAL, INDICATE BOTH)
NOT REQUIRED
SEX
5.
M
F
SINGLE
6. MARITAL STATUS
MARRIED
OTHER (SPECIFY):
(PUT A CROSS IN THE APPROPRIATE SQUARE)
European Organisation for the Safety of Air Navigation – Organisation européenne pour la sécurité de la navigation aérienne
Maastricht UAC, Horsterweg 11, NL-6199 AC Maastricht Airport
Tel. +31 433662017 or/ou 3661340
Email/Mél : [email protected]
http//:www.eurocontrol.int
Fax. +31 433661463
Confidential
7.
GENERAL STATE OF HEALTH (IF DISABLED, STATE
NATURE AND DEGREE OF
GOOD
DISABILITY)
POOR
IF POOR, PLEASE
IMPORTANT: GOOD HEARING AND VISUAL PERFORMANCE ARE ESSENTIAL..
EXPLAIN BELOW
PLEASE INDICATE FULL DETAILS OF YOUR VISION BELOW . IF THE INFORMATION
BELOW ISN’T FULLY COMPLETED, YOUR APPLICATION WILL NOT BE ACCEPTED
REFRACTION IN DIOPTRES
COLOUR VISION
RIGHT EYE
ARE YOU COLOUR BLIND?
LEFT EYE
HAS THERE BEEN EYE SURGERY (E.G. REFRACTIVE SURGERY) OR
AN EYE TRAUMA: If yes please explain
VISION: ADDITIONAL
INFORMATION IF
APPLICABLE
HEARING:
DO YOU HAVE A
SPEECH IMPAIRMENT
OTHER:
8.
KNOWLEDGE OF LANGUAGES
MOTHER TONGUE
UNDERSTANDING
SPEAKING
WRITING
Other
Languages
Listening
Please see below
Common European
Framework
Reading
Spoken
Interaction
Spoken
Production
Levels: A1/A2: Basic user - B1/B2: Independent user - C1/C2: Proficient user
COMMON EUROPEAN FRAMEWORK OF REFERENCE FOR LANGUAGES
9.
REFERENCES: PLEASE GIVE THE NAMES AND ADDRESSES OF THREE PERSONS NOT RELATED TO YOU, WHO KNOW YOU
PROFESSIONALLY AND/OR PERSONALLY.
FULL NAME
CONTACT TELEPHONE NO. OR EMAIL ADDRESS
(i)
(ii)
(iii)
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OCCUPATION OR PROFESSION
Confidential
10. EDUCATION AND TRAINING
GIVE BRIEF DETAILS OF FORMAL EDUCATION SINCE AGE 12. GIVE THE TITLES OF STUDIES, DIPLOMAS, CERTIFICATES ETC. IN THE
ORIGINAL LANGUAGE. PROVIDE COPIES OF RELEVANT DOCUMENTS. STATE FINAL SUBJECTS STUDIED AND RESULTS/GRADES OBTAINED.
USE A SEPARATE SHEET OF PAPER AS REQUIRED. STUDENTS IN THEIR FINAL YEAR MUST PROVIDE DOCUMENTARY AND VALID PROOF
THAT THERE IS A REASONABLE CHANCE OF THEM SUCCEEDING IN THEIR EXAMINATIONS.
MILITARY AND ASSISTANT AIR TRAFFIC CONTROLLERS MUST STATE THE LICENCES THEY HAVE OBTAINED AND THE DATES.
HIGHER SECONDARY EDUCATION (NON-UNIVERSITY)
NAME OF ESTABLISHMENT
NATURE OF STUDIES
(FULL-TIME, EVENING, ETC.)
YEARS (FROM ... TO…)
CERTIFICATES, DIPLOMAS AND/OR
QUALIFICATIONS OBTAINED
UNIVERSITY EDUCATION
NAME OF UNIVERSITY
NATURE OF STUDIES
(FULL-TIME, EVENING, ETC.)
YEARS (FROM ... TO ... )
CERTIFICATES, DIPLOMAS AND/OR
QUALIFICATIONS OBTAINED
11. PROFESSIONAL ACTIVITY / STUDENT HOLIDAY JOBS:
START WITH YOUR PRESENT EMPLOYMENT, AND HIGHLIGHT ANY POSITION RELATED TO ATC OR AVIATION. STATE TITLE
OR FUNCTION IN THE ORIGINAL LANGUAGE OF YOUR EMPLOYER. USE A SEPARATE SHEET OF PAPER FOR ADDITIONAL
PREVIOUS EMPLOYMENT IF REQUIRED.
PRESENT OR MOST RECENT EMPLOYMENT
NAME AND FULL ADDRESS OF EMPLOYER
DATE
FROM
TO
JOB TITLE
DESCRIPTION OF TASKS
(FURTHER DETAILS MAY BE PROVIDED
ON A SEPARATE SHEET)
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PREVIOUS EMPLOYMENT
NAME AND FULL ADDRESS OF EMPLOYER
DATE
FROM
TO
JOB TITLE
DESCRIPTION OF TASKS
(FURTHER DETAILS MAY BE PROVIDED
ON A SEPARATE SHEET)
12. TIME SPENT ABROAD (OTHER THAN SHORT HOLIDAYS)
COUNTRY
YEARS (FROM ... TO…)
REASON
13. INTERESTS:
A)
W HAT ARE YOUR MAIN INTERESTS OR COMMITMENTS OUTSIDE YOUR WORK OR STUDIES?
B)
IF YOU HAVE ANY FLYING EXPERIENCE AS A PILOT, PLEASE DETAIL TYPES OF AIRCRAFT, NUMBER OF HOURS
FLOWN AND LICENCE HELD.
14. AVAILABILITY:
W HEN WOULD YOU BE ABLE TO START A TRAINING COURSE IF ONE WAS OFFERED?
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15. GENERAL QUESTIONS:
YES
HAVE YOU PREVIOUSLY APPLIED FOR EMPLOYMENT WITH EUROCONTROL?
W HEN?
NO
FOR WHICH POST?
HAVE YOU TAKEN ANY SELECTION TESTS FOR AN ATC JOB WITH THE CIVIL OR
MILITARY AUTHORITIES IN YOUR OWN COUNTRY? IF SO,

W AS IT THE EUROCONTROL FEAST TEST PACKAGE

W ERE THE RESULTS?

HAVE YOU ALREADY STARTED A TRAINING COURSE WITH THEM?

IF SO, WHEN WAS THAT COURSE HELD?

DID YOU COMPLETE THE FULL COURSE OF TRAINING?

IF YOU DID NOT COMPLETE THE TRAINING, PLEASE EXPLAIN WHY:
YES
NO
YES
NO
SUCCESSFUL
UNSUCCESSFUL
YES
NO
DATE:
YES
NO
16. USING A SEPARATE SHEET OF PAPER AS REQUIRED, PLEASE ANSWER THE FOLLOWING QUESTIONS AND EXPLAIN IN
ENGLISH, AND IN YOUR OWN WORDS:
A)
W HAT ARE THE DUTIES/RESPONSIBILITIES OF A CONTROLLER?
B)
W HY DO YOU THINK YOU WOULD BE A GOOD CONTROLLER?
C)
W HY DO YOU WANT TO BECOME AN AIR TRAFFIC CONTROLLER?
17. HOW DID YOU LEARN OF THIS COMPETITION?
INTERNET
NEWSPAPER (SPECIFY)
OTHER (SPECIFY)
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W HICH SITE:
Confidential
DECLARATION
(W HICH MUST BE DATED AND AGREED BY THE CANDIDATE)
I, THE UNDERSIGNED, DECLARE THAT THE INFORMATION PROVIDED ABOVE IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND
COMPLETE.
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I UNDERTAKE TO PRODUCE, ON REQUEST, THE ORIGINALS OF ALL THE DIPLOMAS AND/OR CERTIFICATES MENTIONED
ABOVE.
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I AGREE TO UNDERGO THE REQUIRED MEDICAL EXAMINATIONS, IF SELECTED, AND ACCEPT THE CONCLUSIONS REACHED
BY THE AGENCY’S MEDICAL ADVISER.
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I DECLARE THAT I HAVE NO OBJECTION TO AN INVESTIGATION BEING CONDUCTED BY THE COMPETENT AUTHORITIES OF
THE STATE OF WHICH I AM A NATIONAL, WITH A VIEW TO THE ISSUE OF A CERTIFICATE OF SECURITY CLEARANCE WHICH
IS REQUIRED FOR EMPLOYMENT AS A STUDENT CONTROLLER WITH EUROCONTROL. I ACCEPT THAT IF I AM SELECTED
FOR TRAINING, MY APPOINTMENT WILL BE CONDITIONAL ON THE ISSUANCE OF SUCH A CLEARANCE, AND THAT I MAY BE
SUBJECT TO DISMISSAL IN THE EVENT OF ITS REFUSAL.
Please check this box to agree with the above statement
Date:
Name:
PLEASE NOTE THAT COMPLETED APPLICATIONS CANNOT BE RETURNED TO CANDIDATES AND, IF UNSUCCESSFUL, WILL BE
DESTROYED.
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