EASA Part 66 Maintenance

Basic Module Examination Training

Application Form 2018 Organisation

Please enter your personal details below as per official documents (Birth Cert, Passport, etc.) ; Use Block Capitals
SAL ID Code Family Name Given Name Title

Date of Birth (dd/mmm/yyyy) Place of Birth Country of Birth

Please enter your contact details below; Use Block Capitals

Mobile Phone Email Daytime Phone

Mailing
Address

Please indicate your service preference in the fields below; please circle the applicable word.
Result Report Provide Certificate (if passed) Exam Schedule Updates Training Events Updates
Yes / No Yes / No Yes / No Yes / No

Examination Dates,
Select one date only, please note the location of the given date

SNN 17/01/18 18/04/18 08/08/18 21/11/18 dd/mmm/yyyy

Open
Date:
DUB 23/02/18 05/10/2018 Any date entered here must first be agreed with LTSL

Previous Exam Attempts

Please give details of your three most recent attempts for each exam applied for, if this is not completed your application shall be returned.
Exam Category and Module Date (dd/mmm/yyyy) Location Provider

#1

#2

#3

#4

#5

Fees Payable For Administration Purposes Only

Number of examinations selected; 1 to 5 X €65-00 = € Application 1 2 3 4 5 Booked 1 2 3 4 5
Off-Site Admin Fee; 1 or 0 = € Data Upload 1 2 3 4 5 Refused 1 2 3 4 5
For specified venues outside of
Lufthansa Technik Shannon
Total = € Eligibility Check 1 2 3 4 5 Notified 1 2 3 4 5

Disclaimer: Lufthansa Technik Shannon accepts no responsibility for any and all consequences arising out of the exclusion of information, omission of
information, and of errors in the information provided by the candidate.

Declaration: I hereby authorise this application and declare that all information provided herein is correct at this time and that I am not precluded
from taking these examinations for any reason.
I also agree that Lufthansa Technik Shannon may store on an electronic system my personal data provided above and my examination
results, to be used solely for Course, Examination and Certificate administrative purposes.

Signed: Date of Signature:

Form E7-00-03 Rev Date 27.03.15

 EASA Part 66 Maintenance
Basic Module Examination Training
Application Form 2018 Organisation

Please indicate your examination requests by placing an “X” in the corresponding box(es) in the tables below;

Category/
Group Module and Sub-Module Examinations
Required Modules by Category

1 2 3 5 6 7A E 8 9A E 10 E 11A 15 17A
Category A1
Aeroplanes Turbine
Modules:

1 2 3 4 5 6 7A E 8 9A E 10 E 11A 15 17A
Category B1.1
Aeroplanes Turbine
Modules:

Category 1 2 3 4 5 6 7A E 8 9A E 10 E 131 132 14

B2
Avionic
Modules:

Module 7 only running on the following dates –

SNN – 17/01/18 & 08/08/18. DUB 23/02/18
Module 9 and 10 only running on the following dates -
SNN – 18/04/18 & 21/11/18. DUB 05/10/18
Category Extension Examinations (Where a full AML in the “From” Category is held)
From
Full Category B2 6 7A 11A 15 17A
Avionic
to
Category A1
Aeroplanes Turbine
From
Full Category B2 2 6 7A 11A 15 17A
Avionic
to
Category B1.1
Aeroplanes Turbine
From
Full Category A1 1 2 3 4 5 6 7A 8 9A 10 11A 15 17A
Aeroplanes Turbine
to
Category B1.1
Aeroplanes Turbine
From
Full Category B1.1 4 5 7A 131 14
Aeroplanes Turbine
to
Category B2
Avionic
From
Full Category A1 1 2 3 4 5 6 7A 8 9A 10 131 132 14
Aeroplanes Turbine
to
Category B2
Avionic

Limitation Removal Examinations (See PLAM 01-02)

Indicate the BAEC Part(s) you hold and wish to convert, and the Category to which you wish to convert them!

Part 2 Part 4 Part 6
A1 or B1.1 Part 10
A1 or B1.1

BAEC to Part 66
Sub-Modules of
Restriction Removal 
Modules 6, 7A, & 10
Examinations
(involving sub-modules of
Part 66 Modules
6, 7A, 10, 11A and 13)
Part 6 Part 7 Part 8
B2

Sub-Modules of

Module 11A

Form E7-00-03 Rev Date 27.03.15

 EASA Part 66 Maintenance
Basic Module Examination Training
Application Form 2018 Organisation

Instructions on filling out application for EASA Part 66 Basic Module Examinations

For information on SAL Part 147 Authorisations, examination procedures and fees please see www.shannonaerospace.com

Examination Details and Booking Form:

To select an examination:-
1.) In the Category/Group column locate the row corresponding to the examinations which you wish to sit.
2.) In that row place an "X" in the box(es) corresponding to the Module and Sub-Module Examinations which you wish to sit.
3.) From the Examination Dates indicated below select one date. (Each additional date requires an additional application form.)
Please Note: Between one and five of all examination options may be selected for a given date. However it may not be possible to facilitate all of your
examination requests. The examinations to which you are successfully booked, with examination times, will be notified to you in a "Letter of
Acknowledgement".
To select a part or parts of a module exam, i.e. an essay only or a multi-choice exam only, please place the "X" only in the box corresponding to the required
part. For example;
7A E 7A E 7A E
To select Module 7 Multiple To select Module 7 Multiple To select Module 7 Essay only!
Choice exam only! Choice and Essay!
X X X X

On the form; thin frames and numbers indicate where sub-module exams are required.
Bold frames and numbers indicate where full module exams are required.

Two Part Modules

M7, M9 & M10 On the "first attempt" at M7, M9 & M10 examinations both the essay part and the multiple choice part must be taken on the same day.
(e.g. 7ME). The 7E essay is a two question examination. A single fee will cover the essay part and the multi-choice part for a given module on the first
attempt only. Thereafter the essay part and the multiple choice part are administered as separate examinations and individually carry their own fees.
Module essay examinations are generic for Cat A1, B1.1 and B2.

Module 13 Category B2 Module 13 examination is given in two parts. Part 1, designated 131, comprises the B2 Module 13 sub module subjects that are
additional to or are at a higher level than in B1 Module 11.
Module 13 Part 2, designated 132, comprises the B2 Module 13 sub-module subjects that are common to Category B1 Module 11 and which are at the
same or a lower level. (Note: in each case above the sub-module numbers per subject are different).
On the "first attempt" at Module 13, Part 1 and Part 2 examinations must be attempted on the same day and each part carries its own fee. A resit of either
part carries its own fee. Both parts must individually be passed to gain a B2 Module 13 credit. No other recognition is given.

Part 66 License Category Extension sub-modular exams cannot be amalgamated and must be taken as individual exams, incurring their own fees. (Refer to
IAA PLAM 01-03 www.iaa.ie).

BAEC to Part 66 Limitation Removal Examinations refer to IAA Personnel Licensing Advisory Memoranda. (PLAM 01-02 and PLAM 01-07 www.iaa.ie ) The
specified sub-modules from Modules 6, 7A, 10, 11A and 13 will be taken together in one exam except in the case of BAEC Part 10 where two examinations
are required ({6, 7, 10} / {11}). Each Part 66 Limitation Removal Examination requires its own fee.

Full modules required for any conversion/limitation removal must be taken separately and incur their own fees.

Resits: As per EASA Part 66 Appendix II; the maximum number of consecutive attempts at a module examination is three. Further sets of three attempts
are allowed with a one year waiting period between sets.
On application for a resit of a module examination in a given category SAL requests that you provide the names of the Approved Maintenance Training
Organisations' or the Competent Authorities' and the locations and dates in which you attempted that module within the previous 24 months.
Failure to do so may result in your examination being invalidated.

Applications: Application forms with correct payment must be received a minimum of three weeks prior to the requested examination date. Spaces are
limited and will be allocated on a first received and cleared payment basis. Remittance please by Money Order or by crossed Cheque made payable to
“Lufthansa Technik Shannon Limited”. DO NOT SEND CASH by post. Where possible all your examination requests will be facilitated on the day.

Requests for amendment to your application will be considered if notified to the Examinations Administrator at least fourteen calendar days prior to the
applicable examination date. Thereafter, amendments to your application cannot be considered. Requests may not be successful.

Cancellation inside fourteen calendar days of the examination date will result in forfeiture of the examination fee unless the cancellation is notified in
writing to the Examinations Administrator (letter or FAX) and is supported by authoritative documentation (e.g. Doctors Cert or Letter from your Employer).

Failure to attend an examination to which you are booked will result in forfeiture of the examination fees.

Photographic I.D (Passport / Driving License / National Identity Card), a BLACK ink pen and your Booking Confirmation are required on
the examination day.

Please Note: A minimum of three weeks is required to process and publish examination results. A recheck of an examination paper incurs a fee of €120
(refundable if successful) and must be requested in writing with fee within the 60 day period following the date of publication of results,
after which period the exam event is closed.

Applications should be addressed to:

Examinations Administrator, Technical Training, Lufthansa Technik Shannon Limited, Shannon, Co. Clare. Ireland.
Any queries may be redressed by phoning: +353 (0)61-370082

Form E7-00-03 Rev Date 27.03.15