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INDSAILOR Form

This document is an application form for a marine course from INDSAILOR MARINE. It requests personal details such as name, date of birth, address, nationality, passport number, and academic qualifications. It includes sections for the applicant and parent/guardian declarations and a checklist of required documents. The form collects contact information to evaluate candidates for marine course eligibility and communicate regarding their application status.

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Indsailor Marine
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64 views2 pages

INDSAILOR Form

This document is an application form for a marine course from INDSAILOR MARINE. It requests personal details such as name, date of birth, address, nationality, passport number, and academic qualifications. It includes sections for the applicant and parent/guardian declarations and a checklist of required documents. The form collects contact information to evaluate candidates for marine course eligibility and communicate regarding their application status.

Uploaded by

Indsailor Marine
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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FORM-A

INDSAILOR MARINE
E-mail: [email protected]
Website: www.indsailor.page4.me

AFFIX PASSPORT
SIZE
PHOTOGRAPH IN
WHITE SHIRT
COURSE APPLIED FOR: ______________________________________________________________

PERSONAL DETAILS
NAME OF THE APPLICANT: ___________________________________________________________________________
FATHERS NAME: ____________________________DATE OF BIRTH: ____________________________

ADDRESS FOR COMMUNICATION


PERMANENT ADDRESS: _______________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
PHONE: _____________________________________ MOBILE: __________________________________
E-MAIL: _______________________________________________________________________________________________
PRESENT ADDRESS: ___________________________________________________________________________________

_____________________________________________________________________
______________________________________________________________________
PHONE NO.: ______________________________________

MOBILE: _________________________________________

NATIONALITY: _________________________________PASSPORT NO. ________________________________________

ACADEMIC RECORD
QUALIFICATION
10th
12th
ITI/DIPLOMA
B.Sc
B.E / B.Tech
In
.

INSTITTUTE

BOARD/UNIVERSITY

YEAR OF PASSING

PERCENTAGE

FORM-A

INDSAILOR MARINE
IF YOU HAVE ANY CLOSE RELATIVES IN MERCHANT NAVY, PLEASE GIVE DETAILS:
NAME: ______________________________________________________________________________________________________
DESIGNATION: ______________________________________________________________________________________________
COMPANY OF WORK: ________________________________________________________________________________________
CONTACT DETAILS: _________________________________________________________________________________________

DECLARATION BY THE CANDIDATE:


I hereby declare that the information furnished above are true and correct to the best of my knowledge.
I shall abide by the rules and regulations of the company in force, and may be amended from time to time
with regard to fee structure and other details.
PLACE: _____________________________
DATE: ______________________________
(SIGNATURE OF THE CANDIDATE)

DECLARATION BY PARENT / GUARDIAN


I hereby declare that I fully aware of the declaration made by the applicant my son/ward and I declare
and bind myself on the same terms contained in the above declaration.
The information furnished is true, correct and complete.
PLACE: _____________________________
DATE: ______________________________
(SIGNATURE OF PATENT / GUARDIAN)

FOR OFFICE USE ONLY


FOUR (4) SETS OF FOLLOWING DOCUMENTS ARE TO BE ENCLOSED ALONG WITH
APPLICATION FORM:
1.

ATTESTED COPY OF MARKSHEETS

YES / NO

2.

ATTESTED COPY OF CERTIFICATE IN SUPPORT OF DATE OF BIRTH

YES / NO

3.

10 COLOUR PASSPORT SIZE PHOTOGRAPHS (IN WHITE SHIRT)

YES / NO

REMARKS: _______________________________________________________________________________
_______________________________________________________________________________

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