BUREAU OF CIVIL AVIATION SECURITY
MINISTRY OF CIVIL AVIATION
GOVERNMENT OF INDIA
NEW DELHI
REGISTRATION/NOMINATION FORM
Part -I
1. Name of the Candidate:
Passport size (70%
______
(Surname) (First name) (Middle name) face white
background Matte
2. Sex : Male Female finish)
3. Designation of Candidate :-
4. E-mail ID:
5. Mobile No.:-
Signature of
6. Date of Birth ( DD/MM/YY): / / Individual
7. Nationality (Indian)
8. Educational Qualification (Academic)
9. Educational Qualification (Technical)
PART: II
Details of Previous AVSEC Courses Attended by Nominee*
Sr Course Name PERIOD Marks Remarks
No FROM TO RESULT
obtained
*(Note- Non disclosure of any information pertaining to previous AVSEC Courses will
amount to disqualification of the candidate)
PART: III
Working Experience
S.No Organization Designation Period Remarks
From To
AEP No.
Employee Code.
Date:
Signature of the candidate
Place of Posting:
PART:IV
NOMINATION/REGISTRATION FORM
1. Course Name:
2. Exam Centre:
3. Duration of Course - From: To:
4. Name & contact address of Sponsoring Organization: SNV Aviation Pvt Ltd. Urmi Estate, Tower A,
12TH FLOOR, 95, GANPATRAO KADAM MARG, LOWER PAREL (W) MUMBAI-400013
5. Name &Contact address of paying Organization: SNV Aviation Pvt Ltd. Urmi Estate, Tower A,
12TH FLOOR, 95, GANPATRAO KADAM MARG, LOWER PAREL (W) MUMBAI-400013
Declaration by Sponsoring Organization
I certify that the above mentioned nominee is medically fit and fluent in
spoken& writing English. He / She is on regular pay roll of this organization as security employee
and falls within the parameters of the course target population as defined in NCASTP. The security
program of my organization is approved by Competent Authority and the information disclosed
under this form is correct as per best of my knowledge.
1. Name of sponsoring authority:
2. Designation :
Date: Signature with seal
PART: V
(For BCAS use only)
The nomination of Ms/Mr: is accepted/not accepted
Date: Signature of BCAS Official
