Authority to Drive Airside (ADA) Application

This form is to be used when applying for a new Authority to Drive Airside (ADA) or when renewing your current ADA due to its forthcoming expiry.

All persons who drive vehicles on the airside of Alice Springs Airport (ASA) must hold a current ADA. ADA’s are only issued by ASA or an approved issuing authority. The requirements of ADA holders are set out in the ASA Airside Drivers Guide.

PART 1–TO BE COMPLETED BY APPLICANT

ADA Type *

NewRenewUpgradeReplacement (lost/ stolen/ damaged)

Current Category *

124

New Category *

124

First Name *

Last Name *

Mobile: *

Date of Birth *

Address *

Email Address *

Employer *

Position *

ASIC Number *

ASIC Expiry Date *Please consider the last day of the month.

ASIC Upload *

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Have you recently completed the online ADA induction? *

YesNo - Please email me the link

Have you recently completed the Online Security Induction? *

YesNo

Online Security Induction is a mandatory part of ADA applications. Please ensure this is completed via the following link: https://adg.asic.net.au/

ADA applications will be rejected if this is not completed prior to submission.

Employer Email (Authorising Signatory only, see notes below) *This will be the ASA approved Authorising Signatory for your company to sign off this form. To check who the Authorising Signatories are, and avoid any application processing delays, please contact the Airport Management Centre | call 08 8951 1211 or email asa-administration@adgnt.com.au Applications signed by anyone other than an approved Authorising Signatory will be returned.

PART 2 –LICENCE DETAILS

Section A - Drivers Licence

Drivers Licence Number *

Expiry Date *

State/Territory Issued *

Class *

Special Conditions or Restricitons

Upload copy of Drivers Licence *

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Section B - ADA Information

ADA Requested *

Reason ADA is Required *Be specific, explain your role and why it requires an ADA. E.g. Drive Tug for Baggage Loading, Tow Aircraft etc. Reasons such as “work duty” or “operational need” must be expanded on.

Section C - Training

Initial applicants must attach a completed Driver’s Log to this application showing that they have successfully conducted the minimum required hours of training for the category of licence for which they are applying. Driving Airside whilst training must be under the supervision of an experienced ADA holder, equivalent to or higher than the category of licence being applied for:

Category 1: Familiarisation of area (minimum 30 minutes)
Category 2: Four hours
Category 4: Eight hours (at least two of which must be conducted at night)

Note (a): Category 4 ADA will only be issued to applicants who have a requirement to enter taxiways and/or runways in radio equipped vehicles and hold an Aircraft Radiotelephone Operator Certificate.

Note (b): The applicant may be required to sit other Online Inductions if not already completed.

Upload Completed Drivers Log *

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Upload AROC

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Section D - Payment

Payment for ADA applications must be made at the time of submission, no applications will be accepted without payment. Pricing shown is inclusive of GST.

ASA accepts the following payment methods: CASH / EFTPOS / CREDIT CARD / MONTHLY ACCOUNT

Single-Payment Credit Card Authority Form is available for download on our website or request from the Airport Management Centre

www.alicespringsairport.com.au

Are you an ADG employee? *

YesNo

Total amount *

Select Payment Type *

Payment on collection (Cash, Credit Card, Cheque)Credit CardMonthly AccountN/A (please specify)

Credit Card Processing Fees *

Payment Amount *

Credit card details will be asked for at the bottom of this form.

Enter email address to receive Tax Receipt *

Online Receipt Number *

Please specify the reason for N/A *

PART 3 - POLICY STATEMENT

Privacy Statement

We may use your personal information for the purposes of assisting ASA with the correct operating of the airport under various legislation, and in the assessment of any security infractions or incidents. Information may also be supplied to third parties in conjunction with any federal investigations.

By submitting this application, you consent to ASA collecting, using, and disclosing personal information as set out above.

I have read and agree with the Privacy Statement *

PART 4 – CERTIFICATION

Section A - Applicant Certification

I (applicant name) *

Confirm the information provided in this form is correct and agree to notify the ASA Airport Management Centre of any changes to the above particulars;

Confirm that I have read and understood the Airside Drivers Guide for Alice Springs Airport;
Understand that it is a condition of my ADA that I comply with the rules and conditions for driving airside as detailed in the Airside Drivers Guide, the Airside Vehicle Control Handbook and the Airports (Control of On Airport Activities) Regulations 1997;
Understand that failure to comply with the rules for driving airside or the Regulations may result in the suspension or cancellation for any reason;
Understand that I am responsible for advising ASA in writing if I lose or have my State or Territory Driving Licence suspended or cancelled for any reason;
Consent to ASA collecting, using, and disclosing any personal information contained in this application form in accordance with the Privacy Act 1988 and the ASA Privacy policy as detailed on our website
Acknowledge that I have read, understood and accept the ASA Privacy Statement attached to this application form;
The details contained in this application are true and correct and understand I must contact ASA immediately if any of the information changes.

Signature *

Draw signature|Type signatureClear

Date *

By clicking SUBMIT your application will be sent to your Authorising Signatory to sign off.

Section B - Employer Certification. To be completed by Authorised Signatory only

I (print name) *

Of (Company) *

Hereby Certify that:

The applicant as detailed in Part 1 of this form has undertaken the mandatory applicable training as detailed in Part 2, Section C of this form;
I have read and understood the Airside Vehicle Control Handbook for Alice Springs Airport;
I have approved the Category of ADA that the applicant is applying for based on operational requirement;
The applicant will only drive/operate equipment Airside on which they hold current endorsement and has completed appropriate company training and induction; including requirements in relations to an airside vehicle/equipment incident;
I understand that I am responsible for ensuring that ASA are notified immediately in writing if the applicant loses or has their State or Territory Drivers Licence suspended or cancelled for any reason;

Signed *

Draw signature|Type signatureClear

Date *

OFFICE ADMINISTRATION

Is the Authorising Signatory Approved?

YesNo

Approved Authorised Signatory List *Provide list of approved authorising signatories

Is operational need correct? *

YesNo

Operational Access Need Rejection Reason *

ADA Induction Completed

Security Induction Completed

ADA Approved and Printed

Payment

Payment Type *

Payment on collectionCredit CardMonthly Account

Receipt Number (Online payment) *

Receipt Number

Payment Date

Additional File Upload

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Payment NotesEg: 50% reduction due to less than 12 months expiry

CAPTCHA *

Credit Card Payment *

Pay

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