Airside Vehicle Operators Permit Application/Renewal Form

Applicant Information

Permit Type
D D4 DA

First Name

Last Name

Job Title

Home Address

Work Phone

Home Phone

Email Address

RAIC

RAIC #

Driver's Licence

Driver's Licence #

Driver's Licence Class

Driver's Licence Expiry Date

Driver's Licence Restrictions

Restricted Operator Certificate – Aeronautical (ROC-A)

Radio Licence #

Employer Information

Company
 AÉROPORT DE QUÉBEC INC.AÉROPROAGENCE DES SERVICES FRONTALIERS DU CANADAAIR CANADAAIR CANADA MAINTENANCEAIR LIAISONAIR TRANSATAVJET DISTRIBUTIONS INC.AZIMUTH AÉRO-MAINTENANCEBCA AirwaysCFAQCHRONO AVIATION INC.DÉFENSE NATIONALEENTRETIEN MÉNAGER DE LA CAPITALEFLAIRGARDA SECURITY SERVICESGARDAWORLDGARDAWORLD AVIATIONGENDARMERIE ROYALE DU CANADAGLOBAL AIR SERVICESHARNOISHELI-EXPRESSIFLY COLLEGEINLAND TECHNOLOGIESJETSETTERS MAINTENANCE SERVICES INC.K PrimeK'PRIMEKUDLIK AVIATIONLES AILES QUÉBÉCOISESLES CUISINES DE L'AIR (9224-1975 QC INC)LES EXCAVATIONS L.ROBITAILLENAV CANORIZON AVIATIONPAGUIPASCAN AVIATIONPREMIER AVIATION QUÉBEC INC.SERVICE AÉRIEN GOUVERNEMENTALSERVICE DE LA FAUNESPAFAXSTRATEGIC AVIATION SERVICESSUNWING AIRLINESSURETE AEROPORTUAIRESWISSPORTTECHNI-AIR 2000 INC.TestTRANSPORT CANADATSAS

Name of the Requesting Authority

Terms

I hereby certify that, to the best of my knowledge, all of the information provided above is true. This applicant is eligible for the AVOP program and will be trained in AVOP by a qualified operator. Following are the duties of this employee that justify a need and a right to operate a vehicle on airside.