Airport Visitor Identification Card Registration

This form is to be completed by persons requiring access to secure areas of AlburyCity Airport who do not currently hold a valid Aviation Security Identification Card (ASIC) and would like to therefore apply for a Visitor Identification Card (VIC). Please note that pre-registering for a VIC does not guarantee the issue of a VIC.

Fees apply, please see our fees and charges.

All questions of this form must be completed.

Part 1 - Personal Details

First name *

Surname *

Date of birth *

Day Month Year

Employer *

Residential address *

Suburb *

State

Postcode

Country (if residence is not in Australia)

Work phone number *

Mobile phone number *

Email *

Part 2 - ID Details

Type (e.g. Passport, Drivers Lic.) *

ID number *

Expiry date *

Country/state of issue *

ID file *

Part 3 - Access Requirements

From *

Day Month Year

To *

Day Month Year

Areas required to access *

Reason for access * You must be specific in this area; please justify your need to access certain secure areas by stating actions to be carried out.

Passport Photo * Please provide a passport photo for your ID card, e.g. 35-40mm wide & 45-50mm high

Part 4 - ASIC Holder Sponsor Details

First name

Surname

ASIC number

ASIC expiry date

Company

Work phone number

Mobile phone number

Email address

ASIC Sponsor ID Please provide a copy of you ASIC sponsor's ID.

By submitting this form, you agree to the rules and conditions of issue.

Airport Visitor Identification Card Registration

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