Form: CAP-04/011

CHECKLIST FOR CONDUCT OF RATING EXAMINATION

Name of Airport
Unit

A. Personal Details
Name of controller

Designation Employee no.

Date of Joining Date of joining

DD MM YYYY DD MM YYYY
service station
Experience Completed Age
Years Years

B. Class 3 Medical assessment:

1. Date of last class 3 medical assessment
DD MM YYYY

2. Validity of class 3 medical assessment

DD MM YYYY

C. English language Proficiency:

1. English Language Proficiency level
Four Five Six
2. Date of last ELP test ( If below level 6)
DD MM YYYY

3. Validity of ELP level (If below level 6)

DD MM YYYY

D. Rating Details: (Details of ratings held at this station and previous station)
1. Ratings Held at Previous station#
ADC ADC/SMC/ASMGCS ADC/APP
Name of Station______________
APP ACC APP/ACC
#:
For ATCOs transferred from Category I or OCC ADS-CPDLC
Category II airport mention the airport and rating of
the station prior to category I or Category II airport Surveillance APP Surveillance ACC ADS-B*
provided the rating is not more than four years old) *:
Endorsement or fused environment surveillance rating
ADC ADC/SMC/ASMGCS ADC/APP
2. Ratings Held at present station of
posting APP ACC APP/ACC
OCC ADS-CPDLC
Surveillance APP Surveillance ACC ADS-B*
*:
Endorsement or fused environment surveillance rating
3. Eligibility rating for taking into
Rating: _______________________________
account the experience requirement
for reducing the number of OJT Station: ______________________________
hours. Date of last active duty DD MM YYYY

03-May-2019 Checklist for conduct of rating examination Page 1 of 4

 Form: CAP-04/011
E. Training and examination Details
1. Whether new rating? (First rating of the unit at any airport) Yes No

2. Whether similar rating of another station held? Yes No

3. If So, Name of station and year

4. Whether written examination held? Yes No
Not applicable

5. If yes, result of written a. First written exam Pass Fail

examination
Marks (in %)

b. Second written exam, if applicable Pass Fail

Marks (in %)

6. Section/sub-section of MSLTAR –Part 1 applicable for the rating

7. Minimum Number of Days and Hours required for OJT? Days Hrs

8. Amount of total additional training prescribed. 15% 30%

9. Number of Days and Hours completed for OJT? Days Hrs

10. Are mandatory simulator exercises done? Yes No

Not applicable
11. Whether PAB done?
Yes No
Not applicable

12. If yes, result of PAB Pass Fail

Marks (in %)

13. For Surveillance rating, Whether PRB Done? Yes No

Not applicable

14. If Yes, How many PRB done? One Two

15. Result of PRB a. First PRB Pass Fail

Marks (in %)

b. Second PRB, if applicable Pass Fail

Marks (in %)

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 Form: CAP-04/011

16. Result of previous rating board (if any) Pass Fail

Marks (in %)

F. Comments by Training In-charge (Training In-charge may add clarifications/explanation related

to any item above)

G. Verification (By Training In-charge)

Name and Designation Signatures Date

H. Validation: (By ATS In-charge)

Name and Designation Signatures Date

I. Counter signature (By Chairman of Rating Board)

Name and Designation Signatures Date

(Note: Please see overleaf for instructions)

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 Form: CAP-04/011
Note: Attach following documents with check list:
1. Certificate of training course relevant to the rating, attended at training institute or the ratings
certificate issued from the last station of posting as evidence of meeting the knowledge and
experience requirement.
2. Current English language proficiency (ELP) certificate indicating Level and validity
3. Valid Class 3 medical assessment certificate.
4. Result(s) of written exam(s) (answer sheet with question paper).
5. Details of On-the-job- training (hours and days), each entry duly signed by trainee and
instructor and verified by training in-charge.
6. Details of mandatory simulator exercises, each entry duly signed by trainee and instructor and
verified by training in-charge.
7. Result of PAB.
8. Result(s) of PRB(s) if applicable

Legend: ELP: English Language Proficiency; PAB: Progress Assessment Board; PRB: Pre-rating
board; OJT: On-the job training; MSLTAR: Manual of station Level Training and Rating, WSO:
Watch Supervisory Officer.

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