STET Maritime Education Pte Ltd
   
To : Officer-In-Charge Training  
Tel: 6874 7782 Fax: 6874 7666  
   
   
Course:*  
   
   
PERSONAL PARTICULARS
NAME ( IN BLOCK LETTERS ) AND UNDERLINE SURNAME* NRIC / PASSPORT NO.*  
ADDRESS ( IN SINGAPORE ): E-MAIL:  
NATIONALITY* DATE OF
BIRTH*
AGE SEX TEL: / HP RANK
QUALIFICATIONS:  
   
COMPANY PARTICULARS
NAME OF COMPANY ( IN BLOCK LETTERS )*
                 
ADDRESS:* E-MAIL:*  
 
TELEPHONE NO.* FAX NO.* NAME OF CONTACT PERSON & TELEPHONE NO.*  
NEXT OF KIN PARTICULARS
NAME ( IN BLOCK LETTERS ):  
TELEPHONE NO. NRIC / PASSPORT NO. RELATIONSHIP
ADDRESS:
 
PARTICULARS OF CERTIFICATE OF COMPETENCY
GRADE / CLASS CERTIFICATE NO. DATE OF ISSUE DATE OF EXPIRY
PARTICULARS OF SEAGOING SERVICE
NAME & GT OF VESSEL RANK FROM TO
Company's Email will be use for Communication.
If different, please enter email :
  
Type verification image:*