Questionnaire FATIGUE CONCEPTS e-Course

Name you want printed on your certificate
Job Title ---Aviation Safety InspectorAerospace EngineerEngineering ManagerInspection Manager
Company or .gov Email Address
Name you'd like to be called in class
Company or Gov. Telephone Number
Alternate Email Address (gmail, yahoo, ucla.edu, pugrescue.org...)
Personal Telephone Number in case we need to resolve connectivity issues

Supervisor's Email Address
Supervisor's Office Phone Number
What is your prior industry and current job experience?
What aircraft models or components are you currently responsible for?
What do you expect to learn from this class?
Courses you are enrolled for this Training
---MSG-3Aircraft StructuresProbability and ReliabilityFatigue, Fracture Mechanics, and Damage ToleranceAging Aircraft CourseComposites CourseHuman Factors in Repair and Maintenance
Start date of Course
What is your educational background?
Other Fatigue Concepts e-Courses you're interested in
Aircraft StructuresProbability, Statistics, & ReliabilityMSG-3FatigueCorrosionAging AircraftCompositesHuman FactorsAircraft Structural RepairNot at this time
Have you already taken a Fatigue Concepts training course? If so, which one and how many years ago?
I agree not to share or disseminate any substantial portion of the class notes or other info provided by Sam Kantimathi or his instructors, to anyone. I also agree that Structural Integrity, Aircraft Maintenance and allied topics are complex in nature and any information or opinion shared with me by the Instructors during the class, via the notes, through email, WebEx and/or by any other communication is purely advisory in nature. I also agree that in all aircraft structures and associated matters, I will have to refer to the appropriate regulating authority like the FAA, Department of Defense, and/or the Original Manufacturer. I agree to hold Sam Kantimathi, Fatigue Concepts or its employees harmless in any damage resulting from the use of or lack of use of any information provided by Sam Kantimathi, his team of instructors, or Fatigue Concepts. I also agree not to record any portion of the training sessions using audio, video, or other electronic or optical means.

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