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pdfPaperwork Reduction Act Statement: A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to
a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2120-0040. Public reporting for this collection of
information is estimated to be between 40 and 80 hours per response, including the time for reviewing instructions, completing and reviewing the collection of
information. All responses to this collection of information are required to obtain a certificate per 14 CFR Part 147. 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, A63.
Form Approved. OMB No. 2120-0040
08/31/2014
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
2. TELEPHONE NO.
3. ADDRESS (Number, street, city, state, & ZIP Code)
4. TRAINING DIRECTOR
5. APPLICATION SUBMITTED FOR (Check as applicable)
6. RATING(S) APPLIED FOR AND TOTAL
HOURS PER COURSE
ORIGINAL CERTIFICATE
RATINGS
7. MAXIMUM NO. OF STUDENTS
ENROLLED AT ANY ONE TIME
TOTAL HOURS
DAY
EVENING
AIRFRAME (A)
CHANGE IN RATING (Specify)
POWERPLANT (P)
A&P
CHANGE IN OWNERSHIP (Specify)
7A. MAXIMUM TOTAL
SCHOOL ENROLLMENT
CHANGE IN LOCATION, FACILITIES, AND EQUIPMENT (Specify)
8. SCHOOL STATUS (Check as applicable)
CHANGE IN ENROLLMENT (Specify)
NON-PROFIT
PRIVATE
PUBLIC
9. SCHOOL LOCATION (Check as applicable)
OTHER (Specify)
ON AIRPORT
HOURS
PER WEEK
RATINGS
DAY
EVENING
IN CITY
10. COURSE CHARACTERISTICS
ENROLLMENT
INSTRUCTION
WEEKS
PERIODS PER YEAR
HOURS PER
PER COURSE
FOR
DAY
EVENING
DAY
EVENING
DAY
EVENING
IN SUBURBS
ENTRANCE REQUIREMENTS
SCHOLASTIC
PHYSICAL
DAY
YES
NO
EVENING
YES
NO
DAY
EVENING
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
F. SCHEDULE OF REQUIRED TESTS
C. PHOTOGRAPHS OF FACILITIES
G. COPY OF STUDENT RECORD SYSTEM
D. LIST OF INSTRUCTORS- NAMES, CERTIFICATE NOS., TYPE,
AND RATINGS HELD, AND SUBJECTS TO BE TAUGHT
H. OTHER (Specify)
E. LIST OF REQUIRED PRACTICAL PROJECTS
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.
AUTHORIZED SIGNATURE
TITLE
DATE
13. CERTIFICATION ACTION (FOR FAA USE ONLY)
CERTIFICATE NO. ASSIGNED
ACTION
APPROVED
DISAPPROVED
RATINGS
INDICATE RATING(S)
ISSUED
DAY
AIRFRAME (A)
FAA FORM 8310-4 FORWARDED ON
POWERPLANT (P)
A&P
REMARKS
14. DATE CERTIFICATE ISSUED
FAA Form 8310-6 (1-83)
15. OFFICE IDENTIFICATION
16. ISSUING OFFICIAL'S SIGNATURE
EVENING
APPROVED MAXIMUM
ENROLLMENT FOR
DAY
EVENING
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''.
3. TYPE OF INSPECTION AND DATE
2. CERTIFICATE NO.
1. NAME OF SCHOOL
SURVEILLANCE
SESSION
CERTIFICATION
DAY
EVENING
4. SCHOOL CHARACTERISTICS
b. TOTAL NUMBER
OF INSTRUCTORS
a. PRESENT
ENROLLMENT
SESSION
AIRFRAME
POWERPLANT
A&P
CERTIFICATED
NONCERTIFICATED
c. MAXIMUM HRS. TRAINING PER WEEK PER
STUDENT (Exclusive of
lunch or rest periods)
AIRFRAME
POWER
PLANT
A&P
d. RATINGS APPLIED
FOR OR NOW IN
EFFECT
POWER
PLANT
AIRFRAME
A&P
e. DATE OF APPROVAL
FOR CURRICULUM
NOW IN USE
AIRFRAME
POWER
PLANT
A&P
DAY
EVENING
AIRFRAME (A)
POWERPLANT (P)
A&P
5. How many students were graduated during the previous 12 months?
a. Classroom
1 to
1 to
1 to
b. Shop
1 to
1 to
1 to
6. Instructor/student radio.
7. Number of hours in approved curriculum.
Hrs.
Hrs.
YES
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?
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
Hrs.
22. OFFICE IDENTIFICATION
23. INSPECTOR'S SIGNATURE
NO
File Type | application/pdf |
File Modified | 2014-01-15 |
File Created | 2003-10-08 |