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BALAJI SEAMEN TRAINING INSTITUTE

By Manuel Wood,2014-09-25 19:19
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BALAJI SEAMEN TRAINING INSTITUTEBALA

    BALAJI SEAMEN TRAINING INSTITUTE

    (Approved By Dg Shipping Govt Of India, Under Sri Math Narayana Trust)

    ISO 9001: 2008 CERTIFIED INSTITUTE

    City Office : # 27, Raja Street, R.A. Puram, Mandaveli, Chennai 600 028.

    Campus : Chelliamman Kovil Street, Chemmancheri, Chennai 600 119.

    Phone: 044 2493 6477 / 2461 6091 Fax : 044 2461 6027

    E-mail : crajamml@vsnl.net Website: www.bstimarine.com

    APPLICATION FORM FOR ADMISSION TO G. P. RATING

     Recent Application No: Colour Photograph 40mm x 30mm

    PERSONAL DETAILS

     Name : ________________________________________

     Father’s/Guardian Name : ________________________________________

     Sex : ________________________________________

     Date of birth : __________ Place of Birth __________________

     Passport No. : __________ Date of Issue ___________________

     Place of Issue ____________ Validity __________

     Nationality : _____________ Religion ____________________

     Complexion : _______ Eyes _______ Hair ______ Height _____

     Identification Marks : 1. _______________________________________

     2. _______________________________________

    Permanent Address : _________________________________________

     _________________________________________

     _________________________________________

     Contact Address : __________________________________________

     __________________________________________

     __________________________________________

     Next of kin details : Name ________________ Relationship __________

     Address : __________________________________________

     __________________________________________

     __________________________________________

     Qualification : ____________ year of passing _________________

     Percentage of Marks : English : %

     Mathematics : %

     Science : %

     Total : %

     Name of school/College : __________________________________________

     Address : __________________________________________

     __________________________________________

     __________________________________________

    Declaration

    I declare that the information furnished above is true and correct. If proved otherwise

    I shall accept the cancellation of my admission by the Institute.

    I undertake to abide by all the rules and regulation of the Institute in force time to time.

    Place :

    Date :

    Signature of the Applicant

     ________________________________________________________________________________

    For Office Use :

    Admission : Selected / Not selected

    Roll No : Batch No.

    Documents : Verified by

    Approved by Principal

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