ADA Application Form

Note: A license fee of $33.00 (incl. GST) applies and license is valid for the financial year or part thereof. The driving authority will expire on 30 th June of that financial year and will be renewed at AAC’s discretion. Applications are only valid for 20 business days after the Operations Committee approval.

EMPLOYER/BUSINESS NAME

NAME OF ANOTHER EMPLOYEE/PERSON(Required)

STATE/TERRITORY DRIVER LICENCE

(photocopy must be attached)

EXPIRY DATE

CATEGORY OF ADA PERMIT

JUSTIFICATION

(please state the reason for ADA, relevant actions and duties involved)

Which hangars will you be travelling to?

Enter your AUA registration

CAT 3 APPLICANTS ONLY

Aeronautical Radio Operator Certificate (AROC) Licence No.:

EMPLOYER/COMPANY ENDORSEMENT

I certify that the above applicant is required to drive/operate Company vehicles/equipment on the Apron/Taxiways/Runways at Archerfield Airport.

Date

APPLICATION ACKNOWLEDGEMENT AND CERTIFICATION

I acknowledge that, in making this application, I undertake that any vehicle/equipment I use will be operated in compliance with the rules and conditions as promulgated by Archerfield Airport Corporation (AAC), in the Airside Vehicle Control Handbook, which I have read and understood. I further confirm that I have read, understood and accepted the Airport Conditions of Use and Airport User Rules. I acknowledge that AAC may cancel or suspend the ADA, without refund, at any time.

APPLICANT DETAILS

STATE/TERRITORY DRIVER LICENCE

CATEGORY OF ADA PERMIT

EMPLOYER/COMPANY ENDORSEMENT

APPLICATION ACKNOWLEDGEMENT AND CERTIFICATION

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