Application exn. 2 (Pak)




Yüklə 23.36 Kb.
tarix10.04.2016
ölçüsü23.36 Kb.

APPLICATION Exn. 2 (Pak)


FOR

MASTER MARINER AND DECK OFFICERS EXAMINATIONS

Note: - Application should be made at Mercantile Department Karachi, It should be submitted along with certificates of short courses as in NOE or Mark Sheet ( if candidate is appearing for re-examination ) within

10 days before closing date given in annual schedule of that year.
(A) Particulars of Applicant

Name in Full (Block Letters)

Resident Address







Date of Birth

Place of Birth

Nationality










Seaman Book No.

Mobile No.







(B) Previous Certificates (issued in Pakistan or elsewhere, if none; state so)

Title of Certificate


Certificate Number

End. No.

Date of Issue

Date of Expiry

State whether at any time suspended or cancelled and if so: -

(a) By what Court of Authority

(b) Date (c) Cause



Class II / III / IV

Please delete as appropriate















(a)

(b)


(c)

(C) Examination now required

Please tick the appropriate box;


Port at which Applicant desires to be examined and Date

Class-1

Orals




Class-II

Block A Block B Orals

  


Class III

Written Orals

 


Class IV

Written Orals

 



KARACHI /

(D) Certificate of Principal Officer

The Declaration (F) was signed in my presence, and the Fee of Rs. _________ was received by me.

…………………………20…… ……………………………Principal Officer

(E) Certificate of Examiner Mercantile Marine Department, Karachi

Sight Test

Written

Block A Block B

Class III Class IV

Oral


Signaling

Additional sea service (If any)

Certificate of Competency

to be issued



Date

Letter Test

Lantern Test




























…………………………20…… ………...……………Examiner


(F) Declaration to be made by Candidate


(TAKE NOTICE-Any person who makes, or procures to be made, or assists in making, any false representation for the purpose of obtaining for himself or any other person, a certificate of Competency will render himself liable to heavy penalties.)

I hereby declare that the particulars contained in Sections (A), (B) and (C) of this Form are correct and true to the best of my knowledge and belief. And I make this Declaration conscientiously believing the same to be true.


…………………………..20…… ………………………………….

Signature of Candidate


Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©azrefs.org 2016
rəhbərliyinə müraciət

    Ana səhifə