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Exn. 2E (Pak).

No. On Exn
15 E (Pak)

APPLICATION
FOR
ENGINEERS EXAMINATION
Note. Application should be made at a Mercantile Marine Office as many days as possible before the Applicant desires to sit. It
should be handed in at least two weeks before the examination. If it is not convenient for the Applicant to attend at a Mercantile
Marine Office, the form together with the necessary enclosures and the appropriate fee should be sent by post. In this event the
applicant will complete the Declaration (G) in the presence of the Examiner, prior to the Examination.

(A)

Particulars of Applicant.
Name in full (Block letters)

Permanent address

Date of birth (Birth certificate to be produced)


Day
Month
Year

Where born
Town and Country

Nationality

(B) Previous Certificates (Issued in Pakistan or elsewhere; If none state so).


Number

Stream, Motor,
Combined Steam and
Motor

Class

Place and date of: Examination

If any time suspended or cancelled, state: -

Issue

Court of Authority

Date

Cause

(C) Examination now required.


Steam or Motor Academic,
Professional or Orals

Class

Port at which Applicant desires


to be examined and Date
Port

Mercantile Marine Office to


which Certificate is to be sent
(Not for Academic subjects only)

Date

(D) All previous results for the grade of Certificate now required, whether examination taken in Pakistan or United
Kingdom or in another Commonwealth country or in the Irish Republic (if no previous attempts state so)
Where any exemption from Academic Subjects is claimed
sate nature of the exempting qualification:
Day
Month
Year
Port
Time
Subject in which examined and results
PROFESSIONAL
Engineering
Knowledge

ACADEMIC
Applied
Mechanics

Applie
d Heat

Applied
Mathem
atic

Engineer
ing
Drawing

Electro
technolog
y

Naval
Architecture

Orals

Penalty if
any

Candidate should read the Regulations Exn. I E carefully. Copies may be purchased at the Government
Shipping Offices and Mercantile Marine Offices, Karachi.
PL. CROSS APPROPRIATE BOX
Applied
Mechanics

Allied
Heat

Applied
Engineering
ElectroNaval
Engineering
Mathematic
Drawing
Technology Architecture Knowledge

(E) Statement of Service


No. Of
Testimonials

(1) Marine Engineering.

Name and Address


of Firm and Works

Nature of the
business for which
the Works exist

Nature of the work


done by Applicant

Date
From

Period
To

Net qualifying
service

(2) Other Engineering Works

Net qualifying
service

(3) Technical Education.

Orals

Yrs.

Name of School

Courses Attended

Periods of attendance

Certificates Obtained

State whether any remission of service is claimed for the above

(3)

C.D.C. NO. _________

Sea Service
Particulars of sea Service should be taken from the Discharge Book.

Kilowatts
Power
Trade
Rank

Foreign
or
Home

State whether performed


i.
On fitters work,
either by day or on
watches on Deck or in
Engine and Boiler
Rooms
ii.
On regular watch
on auxiliaries of
refrigerator.
iii.
On regular watch
on main engines.
iv.
Do on main
boilers
v.
Do on both main
engines and boilers
simultaneously.

The use of the appropriate


Roman numerals will be
sufficient for III, IV and V.

(4)

Period

From

To

Net qualifying
serve

Days

Official
Number

Dates

Months

Name of Ship and


whether Steam (S.S)
or Motor (M.V)

Nature of Service

Years

No. Of testimonials

Particulars of Previous Certificate (if any)


Class
Date

C.E. & S. S. Ref. No. (if any) CESS..


(F) Certificate of Principal Officer.
*[The Declaration (G) was signed in my presence, and] the fee of Rs.
was received by me.
*Delete in the case of a Postal Application.
.Principal/Officer
at .
. 19
(G) Declaration by Candidate.
To be signed in the presence of the PRINCIPAL OFFICER MERCANTILE MARINE DEPT. OR
EXAMINER.
Take Notice. Any person who makes, or procures to be made, or assists in making, any false
representation for the purpose of obtaining for himself or any other person a Certificate of competency,
renders himself liable to heavy penalties.
I hereby declare that the particulars contained in Sections (A), (B), (C), (D) and (E) of this form are
correct and true to the best of my knowledge and belief and that the PAPERS enumerated in Section (E)
and sent with this Form are true and genuine documents, given and signed by the persons whose names
appear on them.
I further declare that (E) contains a true and correct of the whole of my service without exception.
And I make this Declaration consciously believing the same to be true.
Dated at.this....day
Signature of Candidate

of.. 19..
Present Address
Telephone contact, if any (No. _________________)

Signature of Witness, if an Examiner.


(H) Certificate of Examiner.
Note. The examiner should complete Section II and J and forward the Application as soon as
possible to the Chief Examiner of Engineers. If the Candidate passes, his previous Certificate, if any, must
be attached. The new Certificate will be delivered to the candidate at the office named in Section (C).
ACADEMIC
PROFESSIONAL
State if exempt, previously passed, passed or failed
Date of
Place of
Exempt, previously
Examination
Examination
failed or not
assessed
Applied
Mechanics

Applied
Mathematics

Electrotechnology

Engineering
knowledge

Applied
Heat

Engineering
Drawing

Naval
Architecture

Orals

(J) Personal description of Candidate.

Time penalty
(if any)

Particulars of
Certificate to be
issued

Height
Feet

Color of
Inches

Eyes

Complexion

Personal Marks of
Peculiarities (if any).

Hair

I hereby certify that the particulars in II and J are correct and that Workshop and Sea Service have been
verified by reference to Discharges and Testimonials.
Date.

Examiner..