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APPLIATION FOR STUDENT IDENTIFIATION ARD · 2019. 5. 9. · MARITIME ACADEMY OF ASIA AND THE...
Transcript of APPLIATION FOR STUDENT IDENTIFIATION ARD · 2019. 5. 9. · MARITIME ACADEMY OF ASIA AND THE...
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MARITIME ACADEMY OF ASIA AND THE PACIFIC CENTER FOR ADVANCED MARITIME STUDIES Associated Marine Officers' and Seamen's Union of the Philippines - PTGWO-ITF Kamaya Point, Alas-asin, Mariveles, 2105 Bataan, Philippines
APPLICATION FOR STUDENT IDENTIFICATION CARD
F-029 Issue 0 Revision 1 October 01, 2018
Approved by:
C/E RODOLFO D. PAISO, MSBM
AVP for Post-Graduate/Executive Director
Date: _______________________
Reviewed by:
___________________________
Dean, Center for Advanced Maritime Studies
Date: _______________________
Received by:
_______________________________
Signature over Printed Name Date: ____________________
This application shall not be acted upon unless the following information are received by the Admission Office of the Center for Advanced Maritime Studies, Maritime Academy of Asia and the Pacific, Mariveles, Bataan.
1. Correctly and completely accomplished Application for Student Identification Card.
2. One (1) recent 1 ½” x 2” Passport Size Photo with plain white background. 3. For signature: Please use 1.0 needle point pen.
I further affirm that all information supplied herein are
complete and accurate. I am aware that any or all of the
information furnished in this application may be checked
and that withholding or giving false information will
make me ineligible for student identification card.
Student Signature: Please use 1.0 needle point pen.
Recently taken Passport Size Photo
with Name Tag (1 1/2” x 2”)
Computer generated
or photocopied picture
is not acceptable
ID Number
Needed Information Remarks
Complete Name (LN, FN, MD)
Academic Program
Maritime Rank
Date of Birth
Religion
Complete Address
Contact Number
Blood Type
SSS Number
HDMF Number
TIN
Philhealth Number
In Case of Emergency, pls. contact: