Free AVIATION MAINTENANCE TECHNICIAN SCHOOL CERTIFICATE & RATINGS APPLICATION - Federal

Form Approved. OMB No. 2120-0040 01/31/2008

AVIATION MAINTENANCE TECHNICIAN SCHOOL CERTIFICATE AND RATINGS APPLICATION

U S Department of Transportation Federal Aviation Administration

INSTRUCTIONS: Type or print in ink. Submit original and two copies of this form (complete this side ONLY) and two copies of all attachments to the
nearest FAA General Aviation District Office or Air Carrier District Office as set forth in Federal Aviation Regulations, Part 147.

1. NAME OF SCHOOL 3. ADDRESS (Number, street, city, state, & ZIP Code) 2. TELEPHONE NO. 4. TRAINING DIRECTOR

5. APPLICATION SUBMITTED FOR (Check as applicable) ORIGINAL CERTIFICATE CHANGE IN RATING (Specify)

6. RATING(S) APPLIED FOR AND TOTAL HOURS PER COURSE RATINGS TOTAL HOURS

7. MAXIMUM NO. OF STUDENTS ENROLLED AT ANY ONE TIME DAY EVENING

AIRFRAME (A) POWERPLANT (P)

CHANGE IN OWNERSHIP (Specify)

A&P
7A. MAXIMUM TOTAL SCHOOL ENROLLMENT 8. SCHOOL STATUS (Check as applicable)

CHANGE IN LOCATION, FACILITIES, AND EQUIPMENT (Specify) CHANGE IN ENROLLMENT (Specify) OTHER (Specify)

PUBLIC ON AIRPORT 10. COURSE CHARACTERISTICS ENROLLMENT INSTRUCTION WEEKS PERIODS PER YEAR HOURS PER PER COURSE FOR
DAY EVENING DAY EVENING DAY EVENING

PRIVATE

NON-PROFIT

9. SCHOOL LOCATION (Check as applicable) IN CITY IN SUBURBS

RATINGS

HOURS PER WEEK
DAY EVENING

ENTRANCE REQUIREMENTS SCHOLASTIC PHYSICAL
DAY EVENING DAY EVENING

YES

NO

YES

NO

YES NO YES NO

AIRFRAME (A) POWERPLANT (P)

A&P 11. ATTACHMENTS (Check applicable items)

A. PROPOSED CURRICULUM B. LIST OF FACILITIES AND EQUIPMENT TO BE USED C. PHOTOGRAPHS OF FACILITIES D. LIST OF INSTRUCTORS- NAMES, CERTIFICATE NOS., TYPE, AND RATINGS HELD, AND SUBJECTS TO BE TAUGHT

E. LIST OF REQUIRED PRACTICAL PROJECTS F. SCHEDULE OF REQUIRED TESTS G. COPY OF STUDENT RECORD SYSTEM H. OTHER (Specify)

12. APPLICANT'S CERTIFICATION

NAME OF OWNER (Include name(s) of individual owner, all partners, or corporation name giving State and date of incorporation)

I hereby certify that I have been authorized by the school identified in item 1 to make this application and that statements and attachment hereto are true and correct to the best of my knowledge.
DATE TITLE AUTHORIZED SIGNATURE 13. CERTIFICATION ACTION (FOR FAA USE ONLY) ACTION APPROVED FAA FORM 8310-4 FORWARDED ON DISAPPROVED
REMARKS CERTIFICATE NO. ASSIGNED RATINGS AIRFRAME (A) POWERPLANT (P)
A&P
INDICATE RATING(S) ISSUED
DAY EVENING

APPROVED MAXIMUM ENROLLMENT FOR
DAY EVENING

14. DATE CERTIFICATE ISSUED

15. OFFICE IDENTIFICATION

16. ISSUING OFFICIAL'S SIGNATURE

FAA Form 8310-6 (1-83)

RIS: FS 8310-4

AVIATION MAINTENANCE TECHNICIAN SCHOOL INSPECTION REPORT
(FOR FAA USE ONLY) INSTRUCTIONS: The items listed below are applicable to certification inspection and/or to surveillance. Complete each item. If an item is not applicable indicate entry as ''NA''.
1. NAME OF SCHOOL 2. CERTIFICATE NO. 3. TYPE OF INSPECTION AND DATE SESSION DAY EVENING 4. SCHOOL CHARACTERISTICS SURVEILLANCE CERTIFICATION

SESSION

a. PRESENT ENROLLMENT
AIRFRAME POWERPLANT

b. TOTAL NUMBER OF INSTRUCTORS
CERTIFICATED NONCERTIFICATED

c. MAXIMUM HRS. TRAINING PER WEEK PER STUDENT (Exclusive of lunch or rest periods)
AIRFRAME POWER PLANT

d. RATINGS APPLIED FOR OR NOW IN EFFECT
AIRFRAME POWER PLANT

e. DATE OF APPROVAL
FOR CURRICULUM NOW IN USE
AIRFRAME POWER PLANT

A&P

A&P

A&P

A&P

DAY

EVENING AIRFRAME (A) POWERPLANT (P)

A&P

5. How many students were graduated during the previous 12 months?

a. Classroom 6. Instructor/student radio. b. Shop 7. Number of hours in approved curriculum. 8. Is certificate current and properly displayed? 9. Does the curriculum in use meet the requirements of FAR 147? 10. Is the approved curriculum actually being followed? 11. Do facilities and equipment continue to meet the certification requirements of FAR 147? 12. Are necessary materials, tools, and equipment available and serviceable for training? 13. Is there a sufficient number of qualified instructors?

1 to 1 to Hrs.

1 to 1 to Hrs.

1 to 1 to Hrs.
YES NO

14. Has there been any change in instructor or administrative personnel since the last inspection? (If ''YES, '' explain in Remarks) 15. Is classroom and shop space suitable for courses given and number of students? 16. Are the instructional aids (mockups, projectors, charts, films, etc.) current, specifically applicable to the curriculum, and sufficient for all phases of training? 17. Are there sufficient copies of FAR's. manufacturer's instructions, etc.? 18. Have proper safety measures been taken to insure protection of students operating hazardous equipment including facilities for running engines? 19. Are student records current and do they reflect: a. Daily actual hours students have been in class? b. Progress through courses in the curriculum including accomplishment of laboratory and shop projects? c. Grades for all courses including quizzes, tests. and practical projects? 20. REMARKS AND ITEMS TO FOLLOW UP ON NEXT INSPECTION (Use additional sheets if more space is needed)

21. INSPECTION RESULTS
SATISFACTORY UNSATISFACTORY OTHER

22. OFFICE IDENTIFICATION

23. INSPECTOR'S SIGNATURE

Paperwork Reduction Act Statement:The information collected on this form is necessary to ensure that Aviation Maintenance Technician Schools meet the minimum requirements for the procedures and curriculum set forth by the FAA in FAR Part 147. The information will be used to determine applicant eligibility and compliance. Then all requirements have been met, an aviation maintenance technician school certificate with appropriate ratings is issued. It is estimated that it will take each applicant between 40 and 80 hours to complete this form and provide all the information called for. information is required to obtain a certificate. There is no confidentiality provided. Not that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The control number for this collection is 2120-0040. Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800 Independence Ave SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ABA-20