Appendix A and Evaluation Non-Flight.doc

CERTIFICATE OF TRAINING - APPENDIX A

(NON-FLIGHT)

This Certificate of Training shall be prepared by the contractor and furnished to the FAA as evidence of completion of training for the student indicated.

RETURN OF AN ACCURATELY COMPLETED CERTIFICATE OF TRAINING IS ESSENTIAL SINCE

CERTIFICATION FOR PAYMENT CANNOT BE MADE UNTIL THIS CERTIFICATE IS RECEIVED - - - CERTIFICATE MUST HAVE THE SIGNATURE OF THE STUDENT CERTIFYING RECEIPT OF THE TRAINING HOURS COMPLETED- - -

As soon as the training has been completed, the contractor shall return this certificate together with the other items specified to the following address:

FAA Mike Monroney Aeronautical Center

FAA Academy - ATTN: Contracts and Program Administration Branch, AMA-260

P.O. Box 25082

Oklahoma City, Oklahoma 73125

CONTRACTOR:_________________________________

CONTRACT NUMBER: ______________________________

COURSE:_______________________________________ ORDER NUMBER: _________________________________

TRAINING DATES:

COMPLETION STATUS (circle one): PASS FAIL WITHDRAW INCOMPLETE

I certify that I received the training time as reported herein.

STUDENT SIGNATURE

PRINTED NAME

DATE

CONTRACTOR OFFICIAL SIGNATURE

DATE

****NOTE: FAA Student: Your signature certifies that you received the training time as indicated. Payment will be made from this document. Please complete the course evaluation / course information data on pages 2 and 3.

****NOTE: ANY TRAINING TIME (PER INDIVIDUAL) ABOVE AND BEYOND THAT SPECIFIED BY THE ABOVE REFERENCED CONTRACT / ORDER NUMBER REQUIRES ADVANCE APPROVAL FROM AMA-260.

Revision 6 [5/22/2019]