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VIC Request Form

This VIC Request Form is designed to faclitate a quicker approval process. Applicants who, in the opinion of the Airport Reporting Officer (ARO), do not have legitimate operational need for airside access will be refused access. The applicant and their supervising ASIC holder (if known) will need to be present in person at the airport office with proof of identification (Driver's License or Passport) prior to a VIC pass being issued. VIC passes will only be issued during business hours Monday to Friday or as otherwise agreed by the ARO. The ARO must be contacted on 0428 935 618 to arrange a time for VIC pass collection.

First Name *

Middle Name *

Surname *

Company Represented

(leave blank if not applicable)

Date of Birth *

Day

Month

Year

Address *

Phone Number *

Reason for requiring VIC Pass *

Date From *

Date to be covered by VIC Pass

Day

Month

Year

Date To *

Day

Month

Year

Proof of Identification *

Driver's License or Passport ( include country / state, number and expiry)

Supervising ASIC Holder

Full Name, ASIC Number & ASIC Expiry (leave blank if unknown)

Declaration 1 *

I agree to comply with directions of the Supervising ASIC Holder at all times.

Declaration 2 *

I have not been refused an ASIC or had an ASIC suspended or cancelled due to adverse criminal record.

Declaration 3 *

I have not been issued with a VIC on more than 28 days in the past year.