01. Personal Information Surname: Names: Sex: Male Female Nationality: Date of Birth: N.I.N: Address: Telephone: Email: 02. Select Courses (You may select more than one) BASIC SAFETY COURSES STCW as amended PROFICIENCY ELEMENTARY FIRST AID (15 Hours) PROFICIENCY PERSONAL SURVIVAL AND SAFETY RESPONSIBILITIES (18 Hours) PROFICIENCY PERSONAL SURVIVAL TECHNIQUES (15 Hours ) PROFICIENCY FIRE PREVENTION AND FIREFIGHTING (15 Hours) PROFICIENCY IN SHIP SECURITY AWARENESS (6 Hours) PROFICIENCY IN SECURITY TRAINING FOR SEAFARERS WITH DESIGNATED SECURITY DUTIES (9 Hours) ADVANCED COURSES STCW as amended PROFICIENCY IN MEDICAL FIRST AID (30 Hours) PROFICIENCY IN MEDICAL CARE (30 Hours) PROFICIENCY ADVANCED FIRE FIGHTING (30 Hours ) PROFICIENCY IN SURVIVAL CRAFT AND RESCUE BOAT other than fast rescue boat (30 Hours) SAFETY UPDATING/REFRESHER COURSES STCW as amended PROFICIENCY ELEMENTRY FIRST AID (6 Hours) PROFICIENCY PERSONAL SAFETY & SOCIAL RESPONSILTY (6 Hours) PROFICIENCY IN PERSONAL SURVIVAL TECNIQUES (6 Hours) PROFICIENCY FIRE FIGHTING AND FIRE PREVENTION (6 Hours) PRIFICIENCY MEDICAL FIRST AID (12 Hours ) PROFICIENCY MEDICAL CARE (18 Hours) MARITIME COMMUNICATION GMDSS RESTRICTED OPERATOR'S CERTIFICATE (ROC) (48 Hours) GMDSS GENERAL OPERATOR'S CERTIFICATE (GOC) (90 Hours) ROCP UPGRADE TO ROC (15 Hours ) REFRESHER ROC (6 Hours) BASIC SAFETY COURSES Non-STCW ELEMENTARY FIRST AID (6 Hours) RESPONSIBILITIES (6 Hours) PERSONAL SURVIVAL TECHNICS (6 Hours ) FIRE PREVENTION AND FIRE FIGHTING (6 Hours) BASIC SAFETY COURSES REFRESHER Non-STCW ELEMENTARY FIRST AID (3 Hours) RESPONSIBILITIES (3 Hours) PERSONAL SURVIVAL TECHNICS (3 Hours ) FIRE PREVENTION AND FIRE FIGHTING (3 Hours) MARITIME ENGLISH MARITIME ENGLISH – SUPPORT LEVEL (WITHOUT IGCSE) (60 Hours) MARITIME ENGLISH – SUPPORT LEVEL (WITH IGCSE) (30 Hours) MARITIME ENGLISH – OPERATIONAL LEVEL (WITHOUT IGCSE) (60 Hours) MARITIME ENGLISH – OPERATIONAL LEVEL (WITH IGCSE) (30 Hours) 03. Document Uploads Please attach the following documents as applicable (max 10MB each): 1) National Identity or Passport: 2) STCW / Non-STCW Certificates (for refresher courses): 3) Work Experience / Seaman Book: 4) Educational Qualifications: 5) Medical Fitness Certificate (SMSA approved doctor): 04. Employment Employed: Yes No 05. Swimming Ability Very Good Good Poor Not Able 06. Declaration I declare that the information provided is true and correct.
