A.A. EU Assessment License Application Form

A.A. EU ASSESSMENT LICENSE

Application Form
1. Personal Information
Your Name*

PrefixFirst NameMiddle NameLast Name
Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country*
Contact Number*

Area CodePhone
Your Main Email (For receiving your A.A. EU Assessment License)*
example@example.com
Website / LinkedIn / Social Media Link
Your Company Name*
Job Title*
Types of Businesses*
Briefly describe your work experience. (Ex: the years of employment, promotions, responsibilities, awards, recognitions, etc.) *

2. Information of Renewal License
Country where Issued*
Issued Organization*
License*
Level

Level 1Level 2Level 3Other
Certificate No.*
Issuance Date*

MonthDayYear
Expiration Date*

MonthDayYear
Have you ever been lost or stolen?*

YesNo
Purpose of Renewal your License
Upload your license copy*

Each Certificate in JPG/JPEG/PDF format only and Size of file should be between 50kb – 1000kb.
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Upload your valid ID or passport to verify your identity.*

The size of the scanned image should be between 50kb -100kb in jpg/ jpeg format only.
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3. Background Information
Is this your first time to apply A.A. EU Assessment License?*

YesNo
Based on the safety regulations of the United Nations and the European Union, are you a member or a member of the organizations listed in "COUNCIL DECISION (CFSP) 2019/1341"?*

Abu Nidal OrganisationCommunist Party of the PhilippinesKhalistan Zindabad ForceNone of AboveOther
4. Declaration

A.A. EU ASSESSMENT LICENSE