<p> ATTACHMENT B</p><p>INTERNATIONAL CIVIL AVIATION ORGANIZATION (ICAO) TRANSPORT CANADA</p><p>ICAO/Canada Improving Global Aviation Security Agreement FELLOWSHIP NOMINATION FORM</p><p>Each item must be completed in full and all entries should be typewritten or written in block letters. The completed form should be forwarded to the corresponding ICAO Regional Office for processing.</p><p>ICAO/Canada Programme Cargo and Mail Security Course for Aruba, Bonaire, Curaçao, Guyana, Sint Maarten, Event Name: Suriname and Trinidad and Tobago Event Location: Port of Spain, Trinidad and Tobago Dates of Event: 23 November to 27 November 2015</p><p>PART I – NOMINATION BY CIVIL AVIATION SECURITY (AVSEC) AUTHORITY</p><p>The Government of: AVSEC Authority: Hereby : 1. Presents the Nomination of Mr/Mrs./Miss 2. Date of Birth: 3. Nationality: 4. Job Title: </p><p>5. Brief Job Description: </p><p>6. Contact Work Address (for mailing purposes):</p><p>7. Work Telephone Number: 8. Home Telephone Number: 9. Mobile Telephone Number: 10. Fax Number: 11. E-mail: </p><p>12. AVSEC Authority: certifies that: a) nominee is/will be in possession of a valid passport which does not expire before the termination date of the fellowship. b) all sections of this Nomination Form have been duly completed and the Nominee is suitable for the proposed Training Programme; and c) the nominee’s employment status, rights, salary and seniority will not be adversely affected, during the period of his absence, under the fellowship; d) the nominee is obligated to return to his/her country, on completion of the training event;</p><p>Date: Nominee’s Signature: </p><p>Signature of Authority:</p><p>Name: Signature: </p><p>Title: Date: AFFIX OFFICIAL SEAL OR STAMP ATTACHMENT B PART II – AVIATION SECURITY COURSES/SPECIALIZED TRAINING (Please enlist all ICAO Courses taken as well as any other AVSEC training)</p><p>Name of Training Diploma or Subject Dates attended Institute Certificate</p><p>PART III – RECOMMENDATION BY THE ICAO REGIONAL OFFICE</p><p>The above nominee is selected / not selected for participation in the course.</p><p>Date: Signature: </p>