Authorisation to Release ASL Examination Results This is an authorisation to release your ASL Examination results to New Zealand Aviation. To enable New Zealand Aviation to release your results we must have your written permission in compliance with the Privacy Act 1993 Principle 11 - Limits of the Disclosure of Personal Information.

I _____________________,date of birth ___________residing at ____________________________ ____________________________________________________________________agree to the release of my ASL examination results to New Zealand Aviation.

I _____________________ agree to advise New Zealand Aviation of any changes to my password and acknowledge that this authorisation remains in effect until I advise New Zealand to the contrary.

_____________________________ Signature Date: ______________________

My ASL Student ID is:

User Name:

______________________________

Password:

______________________________

1 of 1