Form 218 - Certificate of Completion/ Acceptance of Experience

Certificate of Completion/ Acceptance of Experience Form
Radio Groups 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12
Form 218_01/2006
CIVIL AVIATION SAFETY AUTHORITY
CERTIFICATE OF COMPLETION
(For Log of Industrial Experience & Achievement [LIEA] used in lieu of CASA SOE)
I certify, that I have completed the LIEA in accordance with the CASA instruction and that it is true in every respect. In doing so I have
physically performed all tasks entered in this section of the LIEA.
NAME:
Form 218_01/2006
ARN:
SIGNATURE:
1
DATE:
/
/
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 1
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Scheduled Maintenance
VHF and HF Communication Systems
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
10 Hours
50 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
2
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 2
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
Audio and Cockpit Voice
Recorder Systems
50 Hours
Scheduled Maintenance
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
3
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 3
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Automatic Direction Finding Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
4
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 4
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
VHF OMNI Range (V.O.R.) Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
5
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 5
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
Marker, Localiser and
Glideslope (ILS) Systems
50 Hours
Scheduled Maintenance
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
6
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 6
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Weather Radar Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
7
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 7
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
A.T.C Transponder Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
Name:
8
.............................................................
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 9
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Radio Altimeter Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
....................................................................
Signature:
Name:
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
.............................................................
9
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 10
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Distance Measuring Equipment Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
....................................................................
Signature:
Name:
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
.............................................................
10
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 11
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Doppler Navigation Systems
Scheduled Maintenance
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
50 Hours
10 Hours
ACCEPTANCE OF EXPERIENCE
Name:
....................................................................
Signature:
Name:
....................................................................
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
.............................................................
11
.............................................................
Region:
Date:
...........................................................................
Region:
Date:
......................................................................
......................................................................
...........................................................................
SUMMARY OF EXPERIENCE FOR AIRCRAFT MAINTENANCE ENGINEER LICENCE
CATEGORY RADIO GROUP 12
ACCEPTANCE OF EXPERIENCE CERTIFICATE
Surname:
EXPERIENCE TASK AREA
Satellite Navigation Systems
Given Names:
Aviation Reference Number (ARN)/AME
Licence Number:
FULL HOURS
20 Hours
ACCEPTANCE OF EXPERIENCE
Name:
Signature:
When completed place a photocopy on AME history file.
Form 218_01/2006
....................................................................
12
.............................................................
Region:
Date:
......................................................................
...........................................................................