Lufthansa Technik AG Concern EASA PART-66 AIRCRAFT MAINTENANCE LICENSE APPLICATION FOR WRITTEN EXAMINATION PLEASE COMPLETE THE FORM IN BLOCK CAPITALS USING BLACK INK 1. PERSONAL DETAILS TITLE SURNAME FORENAME (GIVEN NAME AS IN PASSPORT) DATE OF BIRTH NATIONALITY TOWN OF BIRTH COUNTRY OF BIRTH PERMANENT ADDRESS CITY POSTAL CODE COUNTRY TELEPHONE/ MOBILE ALTERNATIVE TELEPHONE/ MOBILE Lufthansa Technik AG Concern EMAIL ADDRESS ADDRESS FOR CORRESPONDENCE IF DIFFERENT FROM ABOVE CITY POSTAL CODE COUNTRY 2. CATEGORY/ SUB CATEGORY OF EXAMINATION Category B 3. Sub category B1.1 (Aeroplane Turbine) EXAMINATION PAPERS 1. MATHEMATICS 2. PHYSICS 3. ELECTRICAL FUNDAMENTALS 4. ELECTRONIC FUNDAMENTALS 5. DIGITAL TECHNIQUES/ ELECTRONIC INSTRUMENT SYSTEMS 6. MATERIALS & HARDWARES 7. MAINTENANCE PRACTICES 8. BASIC AERODYNAMICS 9. HUMAN FACTORS 10. AVIATION LEGISLATION 11. AEROPLANE AERODYNAMICS, STRUCTURES & SYSTEMS 12. HELICOPTER AERODYNAMICS, STRUCTURES & SYSTEMS 13. AIRCRAFT AERODYNAMICS, STRUCTURES & SYSTEMS 14. PROPULSION 15. GAS TURBINE ENGINES 16. PISTON ENGINE 17. PROPELLER Lufthansa Technik AG Concern APPLICATION form for FOR WRITTEN EXAMINATION EASA PART-66 MODULE EXAM AND OJT PROGRAM 1. CATEGORY/ SUB CATEGORY OF EXAMINATION Category B 2. Sub category B1.1 (Aeroplane Turbine) modules MATHEMATICS, PHYSICS, ELECTRICAL FUNDAMENTALS, ELECTRONIC FUNDAMENTALS, DIGITAL TECHNIQUES, MATERIALS & HARDWARES, MAINTENANCE PRACTICES, BASIC AERODYNAMICS, HUMAN FACTORS, AVIATION LEGISLATION, AEROPLANE AERODYNAMICS, STRUCTURES & SYSTEMS, GAS TURBINE ENGINES, PROPELLER PAYMENT INFORMATION Amount Registration fees - 2,00,000 BDT Tuition fees 1st installment - 6,00,000 BDT Tuition fees 2nd installment - 6,00,000 BDT Tuition fees 3rd installment - 11,00,000 BDT 3. DECLARATION I declare that the information provided in this form is correct. We agree to all rules and regulations of this academic program as per schedule. Signature Applicant