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Home
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AIRCARE
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AIRCARE Safety Programme
> Safety Recognition Award Online Application
Safety Recognition Award Online Application
Safety Recognition Award Application
Name
First
Last
Indicate the level applied for
*
View levels here
Platinum
Gold
Silver
Bronze
Being a member of the Aviation Industry
Association, I/We hereby apply to be assessed for
a Safety Recognition Award at the level indicated.
Name to appear on award
*
Physical Address
Street
Suburb/City
Postcode
Postal Address
Suburb/City
Street
Postcode
Website
Primary Contact
Name
First
Last
Designation
DDI
Mobile
Email
Secondary Contact
Name
First
Last
DDI
Mobile
Designation
Email
Supporting Documentation
In support of this application please provide the following application. Upload files as required
AIA Membership Code
*
Copy of AOC or individual licence
Airworthiness Certificates of Aircraft
registration to appear on the award
Please upload as a single file if more than one
aircraft
Number of hours, or revenue hours operated.
Optional. Please indicate whether you want this to
appear on certificate
Include number of hours or revenue hours operated on Certificate?
Yes, include it on the certificate
Date of incorporation of company, or commencement of operation
Contact details of insurance company
Please attach any other supporting documents below that you believe will be useful in the assessment process
Other
Other
Other
Please check the box to indicate you agree to the
terms and conditions
relating to the Safety Recognition Awards
*
I agree
Name
*
First
Last
Date
*
MM
/
DD
/
YYYY
Image Verification
Please enter the text from the image
:
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