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Forms 103 [[image]] CANADA AIR REGULATIONS, 1938 Application for Airport Traffic Control Officer's Certificate: (To be submitted in duplicate, with two unmounted photographs not larger than 2 1/2 inches by 2 inches.) Controller of Civil Aviation, Department of Transport, Ottawa, Ont. Application is hereby made for an Airport Traffic Control Officer's Certificate. Name_________________________________________________________ (In Block Capitals, Surname Preceding) Permanent address ___________________________________________ Nationality _________________________________________________ Place and date of birth _____________________________________ Details of experience in aviation and certificates held. Pilot________________________________________________________ _____________________________________________________________ Aircraft Owner or Operator___________________________________ _____________________________________________________________ Aircraft Operator or Manager_________________________________ _____________________________________________________________ Radio Operator_______________________________________________ _____________________________________________________________ General______________________________________________________ _____________________________________________________________ _____________________________________________________________ Signature of Applicant _________________________ Date of Application ____________________________ Form 2510
