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) FORENAME
2. ADDRESS EMAIL
Tel. Work
Tel. Home
Mobile Tel.
3. PLACE OF BIRTH DATE OF BIRTH (DD/MM/YY) PRESENT NATIONALITY (IF DUAL, INDICATE BOTH)
4. MILITARY SERVICE COMPLETED NOT COMPLETED NOT REQUIRED
5. SEX M F
6. MARITAL STATUS SINGLE 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 Fax. +31 433661463 Email/Mél : [email protected] http//:www.eurocontrol.int C o n f i d e n t i a l
GOOD POOR 7. GENERAL STATE OF HEALTH (IF DISABLED, STATE NATURE AND DEGREE OF DISABILITY) 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 LEFT EYE ARE YOU COLOUR BLIND?
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 Reading Spoken Spoken Please see below Interaction Production Common European Framework
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 OCCUPATION OR PROFESSION (i)
(ii)
(iii)
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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 CERTIFICATES, DIPLOMAS AND/OR YEARS (FROM ... TO…) NATURE OF STUDIES QUALIFICATIONS OBTAINED (FULL-TIME, EVENING, ETC.)
UNIVERSITY EDUCATION
NAME OF UNIVERSITY CERTIFICATES, DIPLOMAS AND/OR YEARS (FROM ... TO ... ) NATURE OF STUDIES QUALIFICATIONS OBTAINED (FULL-TIME, EVENING, ETC.)
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) WHAT 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: WHEN WOULD YOU BE ABLE TO START A TRAINING COURSE IF ONE WAS OFFERED?
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15. GENERAL QUESTIONS: YES NO HAVE YOU PREVIOUSLY APPLIED FOR EMPLOYMENT WITH EUROCONTROL?
WHEN? FOR WHICH POST?
HAVE YOU TAKEN ANY SELECTION TESTS FOR AN ATC JOB WITH THE CIVIL OR YES NO MILITARY AUTHORITIES IN YOUR OWN COUNTRY? IF SO,
YES NO WAS IT THE EUROCONTROL FEAST TEST PACKAGE
SUCCESSFUL UNSUCCESSFUL WERE THE RESULTS?
YES NO HAVE YOU ALREADY STARTED A TRAINING COURSE WITH THEM?
IF SO, WHEN WAS THAT COURSE HELD? DATE:
YES NO DID YOU COMPLETE THE FULL COURSE OF TRAINING?
IF YOU DID NOT COMPLETE THE TRAINING, PLEASE EXPLAIN WHY:
16. USING A SEPARATE SHEET OF PAPER AS REQUIRED, PLEASE ANSWER THE FOLLOWING QUESTIONS AND EXPLAIN IN ENGLISH, AND IN YOUR OWN WORDS:
A) WHAT ARE THE DUTIES/RESPONSIBILITIES OF A CONTROLLER?
B) WHY DO YOU THINK YOU WOULD BE A GOOD CONTROLLER?
C)
WHY DO YOU WANT TO BECOME AN AIR TRAFFIC CONTROLLER?
17. HOW DID YOU LEARN OF THIS COMPETITION? INTERNET WHICH SITE: NEWSPAPER (SPECIFY) OTHER (SPECIFY)
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DECLARATION
(WHICH 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.
- I UNDERTAKE TO PRODUCE, ON REQUEST, THE ORIGINALS OF ALL THE DIPLOMAS AND/OR CERTIFICATES MENTIONED ABOVE.
- I AGREE TO UNDERGO THE REQUIRED MEDICAL EXAMINATIONS, IF SELECTED, AND ACCEPT THE CONCLUSIONS REACHED BY THE AGENCY’S MEDICAL ADVISER.
- 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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