ETO Application Form

Qualification

Date of Birth

Fields:
Electrical
Electronics
Automation

Years of Industry Experience Note: Industry experience is time you have spent from working in a particular industry or sector related to your profession/licence.

Height (cm)

Weight(kg)

Are you wearing eyeglasses? Yes No

Left Grade

Right Grade

Are you color blind? Yes No

New applicant? Yes No

Personal Information

Enter your personal information for your record.

First Name*

Middle Name

Last Name*

Suffix Name

Permanent Address*

Present Address*

Email*

Mobile Number*

Mobile Number 2

Home Number

Do you have a seaman's book? Yes No

Do you have a passport? Yes No

Have you completed Basic Training? Yes No

Medical declaration

Enter your Medical declaration

Do you have present illness, allergy or medication? Yes No

Do you have past medical history? Yes No

If yes put a check mark on the appropriate box
Asthma - Bronchial/Skin
Cancer or Tumor
Endocrine disorders (Diabetes)
ENT disorders (Ear, Nose, Throat)
Genito Urinary (STD, UT)
Head / Neck injury
Hypertension
Kidney Disease (Polycystic kidney, Lithiasis)

Liver Disease (Hepatitis, Cirrhosis, etc.)
Lung disease (PTB, COPD)
Neurologic disorders - fainting spells, seizures, mental d/o
Viral Infections (Chicken Pox, Measles)

Please Specify(Optional)

COVID Vaccine

First Dose

Date taken i.e. (MM/DD/YYYY)

Second Dose

Date taken i.e. (MM/DD/YYYY)

First Booster

Date taken i.e. (MM/DD/YYYY)

Second Booster

Date taken i.e. (MM/DD/YYYY)

Upload Resume

Upload Resume Note: Acceptable file is PDF only.

DATA PRIVACY CONSENT

I HEREBY CERTIFY that the information provided in this form is complete, true and correct to the best of my knowledge.

The Norwegian Training Center (NTC) of the Norwegian Maritime Foundation of the Philippines Inc. (NMFPI) places utmost importance and respect your right to privacy in all our programs and endeavors. NTC/NMFPI shall handle with utmost care all personal information, sensitive personal information, and privileged information that we may collect from you in accordance with Data Privacy Manual for the purpose of ETO Training Program Application.

I hereby acknowledge and give my consent to allow NTC/NMFPI to use the information gathered in the course of my application for the ETO Cadet Training Program. Should any of my personal data is mishandled/mismanaged in terms of confidentiality without my consent, I may seek assistance with the Data Protection Officer (DPO) of NTC. Contact information: Email: dpo@ntcm.com.ph / Telephone: +632-8799-6830 local 140.

AGREE

Congratulations!

Thank you , your application have been submitted successfully.

ETO Application Form

Step 1

Qualification

Personal Information

Medical declaration

COVID Vaccine

Upload Resume

Congratulations!