Department of Transportation and Communications H

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I PP I
N

P
PUNONGHIMPILAN TANOD BAYBAYIN NG PILIPINAS

E
(Headquarters Philippine Coast Guard)

RD
C
O
139 25th Street, Port Area A
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G
U
A

1018 Manila

APPLICATION FORM

PCG ENLISTMENT/COMMISSIONSHIP

Control Nr.
Coast Guard Officer Course - Commissionship Coast Guards Man Course - Enlistment
Last Name Given Name 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

Inclusive Years Honors/Awards General

EDUCATION

Level Name of School Received Average

From To
High School
Course:
Vocational
Course:
College

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

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Examination Permit

___________________________________________________________
(Last Name) (First Name) (Middle Name)

__________________________________ ____________________
(Place of Exam) (Date of Exam)
Initial Requirements: Important Reminders:
1. Transcript of Records/List of Grades authenticated by School (Xerox) 1. Examinees must bring examination permit,
2. College Diploma / Certificate from School (Xerox) black ballpen & pencil on examination proper.
3. Birth Certificate (Xerox) 2. Applicants must be in casual attire and in proper
4. 2x2 Picture (2 pcs) haircut.
Note: 3. Calculator & cellphone are not allowed during exam.
 No requirements / Incomplete requirements – NO EXAM