Wilhelmsen Ship Management

DECK CADET SELECTION – 2017

APPLICATION FORM

(To be filled in Block Letters)

This is a 2 page form. Please fill, print, scan and send the application form along with scanned copies of the relevant documents as mentioned in item (2) at the end of the form by email to:

Personal Data:

*Full Name (Surname, First Name)

*Father’s/ Guardian’s Name

*Date of Birth(dd/mm/yyyy) *Age (as on 1st May ’17) *Sex

y / y / m / m / M / F

*Correspondence address (*Pin Code is mandatory)

(mandatory)

PIN CODE*

*Telephone No (with STD Code): *Mobile No.: +91

*Email ID (mandatory):

Father’s / Guardian’s Occupation

*Height in Cms *Weight in Kgs

*12th Standard Board (CBSE/ISC/HSC/…etc): * Month/Year of passing/appeared (mm/yyyy)

*Name of School/College and City

*12th PCM % *12th English % * 12th Overall %

(If Results are awaited, fill “RA” in the above % boxes)

*10th Standard Board (CBSE/ICSE/SSC/etc…): *Month/Year of passing 10th Standard (mm/yyyy)

*10th Std English Marks *10th Std Overall %

Are any of your relatives/friends serving in the Merchant Navy? If Yes, who? (If relative – state relationship)

Y / N

Name of company where serving

Describe in your own words, why you are the right candidate for a career at sea:

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General Information: Extra curricular activities / other achievements

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2017 IMU-CET Enrolment No. & Date applied :

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Date Signature of Candidate Signature of Parent/Guardian

Note:

1.  Please read the eligibility criteria & instructions carefully on our website:www.imtcmumbai.org

2. Attach scanned copies of the following documents only in pdf format:

·  Marksheet copies of 12th Std (if results declared).

·  Marksheet of 10th Std.

·  Date of Birth Certificate

3. Do not send any original documents.

4. Ensure you have filled all the (*) mandatory sections of the form.

5. Parents/Guardian must sign the application form.

6. To avoid rejection, please fill this form carefully.

7. Your application will be rejected if any false information has been provided.

8. Management Decision will be final for selection and location of Interview Centre.

9. It is mandatory to appear for the CET conducted by “Indian Maritime University” (IMU) around May’17.

For further details visit IMU website: www.imu.edu.in

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