PTC/FF/EXU/16

Rev: 02, August, 2015

PIA TRAINING CENTRE (PTC)

Basic B1.1 & B2 MODULAR EXAMINATION
REGISTRATION FORM
IMPORTANT NOTICES: Before filling this form please see instructions overleaf.
Complete this form carefully and in capital letters using black or dark blue ink.

1. PERSONAL DETAILS
Full Name:

ARSALAN ALI
ANWAR HUSSAIN
P-66690
Organization: PIA

2 0 1 4 P I A 0 7 6 2

Candidate Ref. No:

Father/Husband Name:
Staff No.:

Place of Birth (City/Country):

Permanent Address:

Date of Birth (dd/mm/yyyy)::

PESHAWAR / PAKISTAN

CNIC:

1 1 0 2 1 9 8 9

0 1 - 4 5 1 3 6 0 2 - 5

HOUSE A-164, BLOCK 2 GULISTAN E JOHAR, KHI

Address for Correspondence (if different from above):

Telephone Number (Mobile) / Office:

- -- -

03205499528

Email Address::

arsalaanali89@gmail.com

2. MODULES I WANT TO APPEAR IN THE EXAM

Please tick box(es) against the Module (s):
MODULES

1. Mathematics
2. Physics
3. Electrical Fundamentals
4. Electronic Fundamentals
5. Digital Tech/Electronic Instrument Sys
6. Materials and Hardware
7. Maintenance Prac. (MCQ )
7. Maintenance Prac. (Essay )
8. Basic Aerodynamics
9. Human Factor (MCQ )
9. Human Factor (Essay )
3. MODULES I ALREADY PASSED

CAT

ATTEMPT

B
B
B

MODULES
10. Aviation legislation (MCQ)
10. Aviation Legislation (Essay)
11a. Turbine Aeroplane Aero, Str & Sys
11b. Piston Aeroplane Aero, Str &Sys
12. Helicopter Aerodyn Str and Sys
13. Aircraft Aerodynamics, Str & Sys
14. Propulsion
15. Gas Turbine Engine
16. Piston Engine
17. Propeller

B
B
B

CAT

ATTEMPT

B
B

2nd

Please tick box(es) against the paper(s):

MODULE
1. Mathematics
2. Physics
3. Electrical Fundamentals
4. Electronic Fundamentals
5. Digital Tech/Electronic Instrument Sys
6. Materials and Hardware
7. Maintenance Prac. (MCQ)
7. Maintenance Prac. (Essay)
8. Basic Aerodynamics
9. Human Factor (MCQ)
9. Human Factor (Essay)
4. DECLARATION

CAT

INSTITUTE

B
B
B

B
B
B

MODULES

CAT

10. Aviation legislation (MCQ)

10. Aviation Legislation (Essay)
11a. Turbine Aeroplane Aero, Str & Sys
11b. Piston Aeroplane Aero, Str &Sys
12. Helicopter Aerodyn, Str and Sys
13. Aircraft Aerodynamics, Str & Sys
14. Propulsion
15. Gas Turbine Engine
16. Piston Engine
17. Propeller

INSTITUTE

B
B

1. I declare that the information provided in this form is correct. For any incorrect information / hiding of information / falsification / use of unfair means
before, during or after the examination, I am liable to be debarred from any further examination for TWO years or I pay a fine of Rs:25,000/=
2. I confirm that my number of attempts for the module, I am applying for, are in accordance with AWNOT-078-Latest Version. Ref-para D4.11 and para D4.12
(para D4.11) A failed basic module will not be retaken for at least 90 days following the date of the failed module examination, except in the case of an ANO-147
organization, which conducts a course of retraining tailored to the failed subjects in the particular module when the failed module may be retaken after 30days.(para
D4.12) The maximum number of consecutive attempts for each basic module is three. Further sets of three attempts are allowed with a 1 year waiting period between
sets.
3. I have read and understood all instructions as given over leaf and as given in latest version of AWNOT-078 or anyother relevant document of PCAA.
Signature of Candidate: ...

28.08.15
Date: ..

5. SUBMISSION INSTRUCTIONS
Submit your completed Form to:
Room # 234, Examination Unit, PIA Training Center , Old Terminal Road Karachi, together with a copy of your CNIC/Employment Card/Passport
along with fee deposit slip, if applicable. (Please bring orginals also) Email address of PTC Examinations: ptc.exam@piac.aero
6. PTC USE ONLY
Date:
Receipt No.

Documents Attached (if any):

INSTRUCTIONS
Important:

The applicant shall not be less than 18 years of age.

An applicant shall be capable of reading and writing the English language.
Examinee must show an acceptable photo ID(CNIC, Employment Card, Passport) to the Examiner at the
time of Examination
Any Communication Devices (Cellular Phones etc), Imaging/Recording devices, Pens, Pencils, study
material/Books, Bags, Coats, Jackets and any other materials not permitted by Examiner are STRICTLY
not allowed in Exam Hall.
Absent cases shall be dealt in accordance with latest version of AWNOT-078 of PCAA.
Exam Fee once submitted can not be refunded in any case.

How to fill this Form:

Fill this form in clear legible capital letters, with BLACK or dark BLUE ink and in the proper
space provided.
Incomplete forms/forms filled in not legible letters will be rejected.
1. PERSONAL DETAILS:

Full Name : Write here your full name.

Email Address : Write here your active Email address.
Staff No: Write here your staff number. If you are unemployed, write PVT
Organization: Write here your Company name in which you are presently working e.g. PIA, SAI, Air
Blue etc. If you are unemployed write PVT.
Date of Birth: Write here your date of birth in dd-mm-yyyy format, for example if you were born on 24th
November 1990,write 24-11-1990.
Place of Birth: Write here city & country of your birth.
Permanent Address: Write here your complete permanent address.
Address for Correspondence: Write here your address for correspondence if it is different from above.
If it is same as above- write SAME AS ABOVE
Telephone No. (Mobile): Write here your mobile phone number/s.
Telephone No. (Office): Write here your complete office phone number including city code and with
extension if any eg City code-phone number/extension. If you are unemployed write PVT.

2. MODULES I WANT TO APPEAR IN THE EXAM:

Tick the applicable box against the Module Exam you want to appear.

CAT of Exam applied.

If the Module level is different for B1 & B2, write B1 or B2 as per you wish to appear in category of
exam, regardless of your category eg Aerospace or Avionics.
ATTEMPT: If you are appearing for the first time in the Module Exam of that module,
write FIRST, if you failed once & appearing second time in that module exam, write SECOND, if you
failed twice in that module exam, write THIRD if you failed thrice in that module exam and so on.

3. MODULES I ALREADY PASSED: (This has NO concern with the Modules you passed while attending a
course of training)
Tick the applicable box against Module you already passed.
INSTITUTE: Write the name of institute from where you passed the Modular Exam.
4. DECLARATION: Please read carefully and sign with date.

5. SUBMISSION DETAILS: Follow the guide lines.

6. PTC USE ONLY: Leave this portion blank.