6
sue 1 Rev.
Apel 17,2018
MARITIME ACADEMY OF ASIA AND THE PACIFIC-KAMAYA POINT.
BOARD OF ADMISSIONS 2x2
‘Asscitd Marne Oe nd Seame's Union fhe Philipines ~PTOWO- ITF RECENT
Berto] Kimaye trey. Alasanin Marts aan COLORED
PICTURE
MIDSHIPMAN APPLICATION FORM
Cawosur dependent Clcotege tev Cl Senior Hah Schoo! | Ty ways) eam
= [Tasttame Given Name = iidale Name ‘eae wil
<
z =
Home Adaress Ze Code Resin
° — - a
= | Ea Aaaress Contact Number Gender
Pa Dise — Orenae
ich cate (ox January 07, 200%) | Age | Staton | Binh pace Retin eight ema) | Weight ibs! ka)
Porenis Name ‘Ags | AMOSUPLD. No. | Occupation ving Deceased
> [toner
| Beouiveayaesabroaa? Nene? eisionship | Rank/Posiion | Gompanyi Location
Foro!
Publi JPrvate en
| Schoo! sro ee i
Hoh] Name of Sehoat
seoo!
cise |
2) Name a Seho6T
° a
| a racecars
S| SRR" | o Acaaemic /srand
5. | $ete2! | 1 Technical Vocationaltiveihood / Specialization
a O Spots
fa Ais and Design
Name of Schoo! =
cotege
Level Programas =
T hereby certify that the above information are trae and correct.
NOTE: The MAAP-Board of Admissions recognizes ther responsibilities under the Republic Act No, 10173 (Act), also known as the Data Privacy
‘Act of 2012, with respect of the data they collect, record, use, and consolidate from the applicant. The personal data to be obtained is forthe purpose
lf admission and selection processing of MAAP and respective sponsoring companies.
‘By affixing your signature on His application form, you expressly give your consent to MAAP-Board of Admissions to collect, record, use,
process ani consolidate the personal data you voluntarily indicated herein for purposes above-mentioned.
x Applicant's Signature /Date
DO NOT FILL-IN THIS PART (MAAP Use Only)
[AAP Examination Grade | Application Statue Evaluators Remarks Evasion
Ol Accepted denied
Pace of Testing Contr ‘Examination Datel Time
CAN BE PHOTOCOPIED. NOT FOR SALE.
3
* $4) MARITIME ACADEMY OF ASIA AND THE PACIFIC
KAMAYA POINT
‘rie Marin Officers and Sean's Unio ofthe Pillpins - PTOWO-T
Kameya Pt Dy. Al-rin Marve, aaa 2x2
Bal #
ENTRANCE EXAMINATION PERMIT eaieeey
ae RE Feared Pa PICTURE
[Ons Cl aoe
ac ot Taxing Car — Traninaton a Tne
ode of Payment 3 ‘Teat Permit Na. [Evaluator
cash OC check’ Money Order Payable to MAAP
‘RING THE FOLLOWING ON THE SCHEDULED EXAMINATION Nore
taierat Sse br Fer 1 Tir ol alowed dng te earinaton
2 Vald School 1 4. Pencttlongst No.2) 2. Fala to subrt alton reaurements may bea ground fr savin,