Form. No.

PEL-FLC 270
APPLICATION FOR AN ENGLISH
Revision 1 LANGUAGE PROFICIENCY (ELP) GROUND
Page No. 1 of 3 EXAMINATION

Revision Date: 11/09/2023 (ALL FLIGHT CREW LICENCE CATEGORIES)

A list of current ELP L.A.Bs is available on the HCAA website at https://hcaa.gov.gr/en/language-assessment-bodies-labs

Please complete the form in BLOCK CAPITALS having read the pre-test briefing notes supplied by the Examiner.

1. PERSONAL DETAILS

HCAA Licence Reference No. (if known)

Surname ......................................................................................... First Name(s) …...............................................................................

Title (Mr / Mrs / Ms etc) ................................................................... Date of Birth (dd/mm/yyyy) .............................................................

Nationality ....................................................................................... Place of Birth (Town) …....................... (Country) ….......................

Permanent address ………........................................................................................................................................................................

...........................................................................................................………………………………………..Postcode ................................

Contact Tel. No. ............................................................................. Mobile Tel. No. ...............................................................................

E-mail address ................................................................................ Fax Number ....................................................................................

Language Assessment Body(L.A.B) .......................................................................................................................................................

...........................................................................................................……………………………………………………………………………

2. DETAILS OF FLIGHT CREW LICENCE(S) HELD (if applicable)

State of Issue Type of license (e.g. SPL, Class, Type & Instrument License No. Expiry Date
PPL, CPL, ATPL, F/E) & Ratings endorsed on
Category of License License
(e.g Aeroplane, Helicopter etc)

3. DETAILS OF PREVIOUS ENGLISH LANGUAGE PROFICIENCY (ELP) EXAMINATION(S) UNDERTAKEN

(Note : If no ELP test has previously been undertaken, please enter “NONE”

Date of Test State where tested Examiner’s Name Examiner’s Result of Test
Authorization No. (i.e., ICAO Level 1 to 6)

4. APPLICATION (tick as appropriate)

I am applying for the PART-FCL English Language Proficiency (ELP) ground examination indicated below:-

SPL (A) PPL or CPL (SPA) CPL or ATPL (MPA) Flight Engineer (MPA)

SPL (H) PPL or CPL (SPH) CPL or ATPL (MPH) Other (specify)……………..
 Form. No. PEL-FLC 270
APPLICATION FOR AN ENGLISH
Revision 1 LANGUAGE PROFICIENCY (ELP) GROUND
Page No. 2 of 3 EXAMINATION

Revision Date: 11/09/2023 (ALL FLIGHT CREW LICENCE CATEGORIES)

5. APPLICANT’S DECLARATION

I hereby declare that the information given in this form is true and correct to the best of my knowledge and belief. I have presented
the required photographic evidence of my identity.

Applicant’s Signature ................................................................................................................... Date ....................................................

Note: It is an offence for a person to make, procure to be made, or assist in making any false representations for the purpose of
procuring for any reason the issue, validation, extension or re-issue of a license or the issue, renewal or revalidation of a rating,
authorization or certificate, or the applicable Part-FCL Requirements, whether for that person or any other person.

6A. ASSESSOR 1 EVALUATION

ICAO Pronunciation Grammar / Vocabulary Fluency Comprehension Interaction

Headings: Structure
Level Result
(Number):

Overall Assessment is the Lowest Score in above Result Boxes (Minimum Pass is Level 4):

Comments:

6B. ASSESSOR 2 EVALUATION

ICAO Pronunciation Grammar / Vocabulary Fluency Comprehension Interaction

Headings: Structure
Level Result
(Number):

Overall Assessment is the Lowest Score in above Result Boxes (Minimum Pass is Level 4):

Comments:

6C. ADDITIONAL ASSESSOR(S) EVALUATION (IF APPLICABLE)

ICAO Pronunciation Grammar / Vocabulary Fluency Comprehension Interaction

Headings: Structure
Level Result
(Number):

Overall Assessment is the Lowest Score in above Result Boxes (Minimum Pass is Level 4):

Comments:
 Form. No. PEL-FLC 270
APPLICATION FOR AN ENGLISH
Revision 1 LANGUAGE PROFICIENCY (ELP) GROUND
Page No. 3 of 3 EXAMINATION

Revision Date: 11/09/2023 (ALL FLIGHT CREW LICENCE CATEGORIES)

7. OVERALL ASSESSMENT RESULT

ICAO
ASSESOR 1 ASSESOR 2 ADDITIONAL ASSESOR (if applicable)
Headings:
Level Result
(Number):

FINAL
GRADE:

I hereby declare that I have verified the required photographic evidence of the applicant’s identity.

Form of photographic Identification presented:

Driving license (State of Issue ………………………………….. Document No. ...................................................... )

Passport (State of Issue ………………………………….. Document No........................................................ )

Examiner’s Signature ................................................................................................... Date ..............................................................

Examiner’s Name (BLOCK CAPITALS) ……………………………………………………Examiner No. ………………………………….

SUBMISSION INSTRUCTIONS

Please, send your application along with the following attachments to [email protected] with the following Subject: PEL - ELP -
(License Number if available & Last Name) if you require only your ELP to be updated in your license and your license to be
reissued
Eparavolo Codes
Please enclose the following:-
Initial PPL 8780 PPL Reissue 8781
e-Administrative Fee Code-eparavolo. 8782 CPL Reissue 8783
Initial CPL
LAB Certificate or equivalent or Assessor Certificate as applicable Initial ATPL 8784 ATPL Reissue 8785

In case you are submitting this application as part of another application, the eparavolo codes above do not apply. Only the eparavolo
codes from the respective application apply.

For HCAA Use Only:

Application Review:
Issue Do not Issue

Approved by HCAA Authorized

Officer (Name):
Signature: Date: