<table>
<colgroup>
<col style="width: 13%" />
<col style="width: 9%" />
<col style="width: 0%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 15%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 17%" />
<col style="width: 4%" />
<col style="width: 2%" />
<col style="width: 10%" />
<col style="width: 16%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="3"><p id="step-1" class="heading">Step 1</p></td>
<td colspan="10"><p id="originator-pcn" class="heading"> Originator PCN
#      </p></td>
</tr>
<tr class="even">
<td colspan="7"><p>Originator:</p>
<p>     </p></td>
<td colspan="5"><p>Position/Title:</p>
<p>     </p></td>
<td><p>Branch:</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="5">Course Number:      </td>
<td colspan="8">Course Title:      </td>
</tr>
<tr class="even">
<td colspan="13">Reason for this change:      </td>
</tr>
<tr class="odd">
<td colspan="9">Signature:      </td>
<td colspan="4">Date Initiated:      </td>
</tr>
<tr class="even">
<td colspan="3"><strong>Step 2</strong></td>
<td colspan="10"><strong>Branch Manager</strong></td>
</tr>
<tr class="odd">
<td> Concur</td>
<td colspan="12"><blockquote>
<p> Do not concur Reason:     </p>
<p><u>NOTE:</u> If the product content does not match FAA Rules and
Guidance, refer to Control of Nonconforming Products procedure – QP
221</p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="6"> Major Change Minor Change</td>
<td colspan="7">Change Requires Coordination with Sponsor Yes No</td>
</tr>
<tr class="odd">
<td colspan="11">Name and Signature:</td>
<td colspan="2">Date:</td>
</tr>
<tr class="even">
<td colspan="2"><strong>Step 3</strong></td>
<td colspan="11"><strong>Originator</strong></td>
</tr>
<tr class="odd">
<td colspan="2"><p>Action Taken:</p>
<p> Coordinated with Sponsor</p>
<p> Changes made</p>
<p> Changes properly posted</p>
<p> Old material archived</p></td>
<td colspan="8"><p>New Lesson Revision (list all lessons):</p>
<table style="width:100%;">
<colgroup>
<col style="width: 7%" />
<col style="width: 12%" />
<col style="width: 7%" />
<col style="width: 12%" />
<col style="width: 8%" />
<col style="width: 12%" />
<col style="width: 7%" />
<col style="width: 12%" />
<col style="width: 7%" />
<col style="width: 12%" />
</colgroup>
<tbody>
<tr class="odd">
<td>1</td>
<td></td>
<td>2</td>
<td></td>
<td>3</td>
<td></td>
<td>4</td>
<td></td>
<td>5</td>
<td></td>
</tr>
<tr class="even">
<td>6</td>
<td></td>
<td>7</td>
<td></td>
<td>8</td>
<td></td>
<td>9</td>
<td></td>
<td>10</td>
<td></td>
</tr>
<tr class="odd">
<td>11</td>
<td></td>
<td>12</td>
<td></td>
<td>13</td>
<td></td>
<td>14</td>
<td></td>
<td>15</td>
<td></td>
</tr>
<tr class="even">
<td>16</td>
<td></td>
<td>17</td>
<td></td>
<td>18</td>
<td></td>
<td>19</td>
<td></td>
<td>20</td>
<td></td>
</tr>
<tr class="odd">
<td>21</td>
<td></td>
<td>22</td>
<td></td>
<td>23</td>
<td></td>
<td>24</td>
<td></td>
<td>25</td>
<td></td>
</tr>
<tr class="even">
<td>26</td>
<td></td>
<td>27</td>
<td></td>
<td>28</td>
<td></td>
<td>29</td>
<td></td>
<td>30</td>
<td></td>
</tr>
<tr class="odd">
<td>31</td>
<td></td>
<td>32</td>
<td></td>
<td>33</td>
<td></td>
<td>34</td>
<td></td>
<td>35</td>
<td></td>
</tr>
</tbody>
</table></td>
<td colspan="3"><p>Date:</p>
<p>Signature:</p></td>
</tr>
<tr class="even">
<td colspan="2"><strong>Step 4</strong></td>
<td colspan="11"><strong>Branch Manager</strong></td>
</tr>
<tr class="odd">
<td colspan="2"> Material postings verified</td>
<td colspan="11">Revision requires notification to previous students:
Yes No</td>
</tr>
<tr class="even">
<td colspan="11">Signature:</td>
<td colspan="2">Date:</td>
</tr>
<tr class="odd">
<td colspan="3"><strong>Step 5</strong></td>
<td colspan="10"><strong>Originator – If Notification is
Required</strong></td>
</tr>
<tr class="even">
<td colspan="4"> Notification Complete</td>
<td colspan="9">Notification Method:      </td>
</tr>
<tr class="odd">
<td colspan="8">Signature:</td>
<td colspan="5">Date:      </td>
</tr>
</tbody>
</table>

  ------------ ------------------------------------------ ------------ -----------
  **REVISION                                                           
  HISTORY**                                                            

  **Rev.**     **Description of Change**                  **Author**   **Eff.
                                                                       Date**

  Original                                                GLH          1/8/2008

  1            Added spot for Log Number                  GLH          1/15/2008

  2            Added blocks to note revision levels of    GLH          2/10/08
               all lessons                                             
  ------------ ------------------------------------------ ------------ -----------