Department of Transportation and Communications PUNONGHIMPILAN TANOD BAYBAYIN NG PILIPINAS (Headquarters Philippine Coast Guard) 139 25th Street,

Port Area 1018 Manila APPLICATION FORM PCG ENLISTMENT/COMMISSIONSHIP

Control Nr.

I PP I IL N

O A

ST

Coast Guard Officer Course - Commissionship

Last Name Given Name

Coast Guards Man Course - Enlistment

Middle Name

PERSONAL

Permanent Address

Region

Birthdate

Birth Place

Religion

Zip Code

Contact Number (Cellphone / Landline)

Sex

Age

Civil Status

Height

Weight

Father's Name

Age

Occupation

Living/Deceased

FAMILY

Mother's Name

Age

Occupation

Living/Deceased

Parent's Mailing Address

Contact Number

EDUCATION

Level High School Vocational College

Course:

Name of School

Inclusive Years From To

Honors/Awards Received

RD A

General Average

Course:

I hereby certify that the above information are true and correct Applicant's Signature Examination Date / Time Interviewer's Signature

---------------------------------------------------------------------------------------------------------------------------------Examination Permit ___________________________________________________________ (Last Name) (First Name) (Middle Name) __________________________________ (Place of Exam)
Initial Requirements: 1. Transcript of Records/List of Grades authenticated by School (Xerox) 2. College Diploma / Certificate from School (Xerox) 3. Birth Certificate (Xerox) 4. 2x2 Picture (2 pcs) Note: No requirements / Incomplete requirements NO EXAM

____________________ (Date of Exam)

Important Reminders: 1. Examinees must bring examination permit, black ballpen & pencil on examination proper. 2. Applicants must be in casual attire and in proper haircut. 3. Calculator & cellphone are not allowed during exam.