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PERSONAL DETAILS NAME (as it is to appear on official documentation): Date of birth: Sex: Marital status: Citizenship: HOME ADDRESS: BUSINESS ADDRESS:  Telephone: Fax: Email: _______________________________________________________ EDUCATION Please list your academic qualifications, and attach certified copies of certificates and transcripts. University or equivalent Date Date Qualification Subject(s) institution, city and country from to: awarded: _ _ _ _ _ ____ __________ _ _ _____ ____ _ _ ___________ _ __________________________ _ _ _____ ____ _ _ ___________ _____ ___________________________________________________________ ENGLISH LANGUAGE Please note that all applicants must attach a certified copy of an English language certificate. Date taken Result/mark International English Language Testing System (IELTS) _ __ ___________ Test of English as a Foreign Language (TOEFL) ___________ ___________ Cambridge Examinations (PET/FCE/CPE) ___________ ___________ ____________________________________________________________________ COMPUTER SKILLS Please note that all applicants must have computer skills. Please see the Academic Handbook for more details. Which computer software packages do you use regularly? ×word processing ×Excel or other spread sheets ×email/internet ð×other (please specify) Simple programme database and adobe __________________________________________________________________________________ PROFESSIONAL QUALIFICATIONS Please list relevant professional qualifications, and attach certified copies of certificates Institution, city and country Date Date Qualification Subject(s) from: to: awarded: Do you have experience as a seafarer? YES / NO ____________________________________________________________________________________ EMPLOYMENT Please list the posts you have held over the last ten years, starting with your current job. Employer Date Date Position/Department from: to: ___________________________________________________________________________ APPLICANT'S DECLARATION I certify that the statements made by me on this form are true, complete and correct to the best of my knowledge and belief. I understand that any false statements or omissions may provide grounds for the withdrawal of any offer of enrolment or for summary dismissal from the University. If selected, I understand that I am expected to: • conduct myself at all times in a manner compatible with my status as a student of the World Maritime university; • study full time during the period of the course, as directed by the University; Signature: ___ _ _____ Date: _     
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