National aviation university icao institute icon

National aviation university icao institute




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НазваNational aviation university icao institute
Дата11.09.2012
Розмір10.69 Kb.
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NATIONAL AVIATION

UNIVERSITY


ICAO INSTITUTE



Cosmonaut Komarov ave., 1, Kyiv, 03058, Ukraine, tel./fax +38 (044) 4576912, e-mail: eduicao@nau.edu.ua, http://.icao.nau.edu.ua


TRAINING/TESTING APPLICATION FORM


Surname ______________________ Name _________________Middle name___________________

Position _________________________________________Work experience_____________________

Last qualification improvement courses completion (specify date and location)___________________ __________________________________________________________________________________

^ Mail address:  personal  business ___________________________________________________

__________________________________________________________________________________

Telephone_________________Fax_________________ Cell phone___________________________

E-mail ____________________________________________________________________________

Enterprise/organization_______________________________________________________________

Taxpayer registration certificate № _____________________________________________________

Enterprise/organization tax identification number№ ________________________________________

Enterprise/organization manager name___________________________________________________

Enterprise/organization manager position________________________________________________

Enterprise/organization postal address___________________________________________________

Enterprise/organization legal address____________________________________________________

Telephone _______________________________ Fax_______________________________________

Bank account details:_________________________________________________________________

__________________________________________________________________________________

Number of persons willing to pass the training/testing_______________________________________

Training/testing on the course __________________________________________________________

______________________________________ from_______________ till_________________ 20___


Date _____________________________________ Signature ________________________________

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