1.
2.
3.
Read these instructions carefully and follow them accurately .
Answer each question clearly and completely.Type or write in BLOCK CAPITAL letters.
The following documents must be attached with this application.
a. Four copies of recent passport size coloured photograph (to be pasted in the spaces provided on page # 2,4 &5) .
b. Two spare photographs sealed in an envelope with Name and Fathers Name written on the reverse side of
each photograph and duly signed & attested by your Principal or a Government Officer of Grade 17 or
above.
c. Attested photocopies of :
Matriculation / Equivalent certificate.
H.S.C. / Equivalent marks sheet (Candidates awaiting results to provide H.S.C.-I(First Year) / Equivalent
marks sheet alongwith a certificate from their College Principal that they have a good chance of passing
the H.S.C. / Equivalent examination in at least 2nd Division.)
NIC or Form B of the candidate.
Domicile Certificate ( If own Domicile Certificate has not been issued then attach fathers domicile)
NIC of father/guardian
d. Must attach Bank draft/Pay order (Original, not photocopy) of Rs.1500/- (Non-Refundable) in favour of
PAKISTAN MARINE ACADEMY KARACHI, NBP MAURIPUR BRANCH
4.
5.
6.
7.
8.
9.
10.
11
Original certificates listed at para 3 (c) shall be submitted by the finally selected candidates at the time of joining
the Academy.
The original documents will be verified from the originating authority. Documents found fake / tampered would
be rejected and the canditate will be liable for legal action in addition to expulsion from training .
Return all five pages of this form so as to reach Pakistan Marine Academy by 10th August, 2011.
Final allocation of Branch will be made by the Pakistan Marine Academy.
Any change of postal address should be promptly notified to the Cadet Training Coordination Officer of
Pakistan Marine Academy.
Selected candidate will be informed of the result of their application in due course . You are advised to visit the
PMA website regularly for updates .
Candidates are cautioned that:
(a)
If a candidate is found to have knowingly furnished any particulars which are false or misrepresented or
has concealed any information, he will be disqualified for admission and expelled from training.
(b)
If the application is incomplete or incorrectly filled or is not accompanied by all the documents
mentioned in paragaph 3 above, it is liable to be summarily rejected and no appeal against its rejection
would be entertained.
(c)
Candidates will not be allowed to change their option for Branch and Stations at S. No. 7,8 and 9 of the
Application Form for Admission.
(d)
Application forms received with false, tampered or illegible document(s) will be rejected summarily
and no appeal against its rejection would be entertained.
For any queries / clarifications, please visit our website www.marineacademy.edu.pk
OR
Contact:
CADETS TRAINING COORDINATION OFFICER
Pakistan Marine Academy
Hawksbay Road Mauripur Karachi-75780
Tel: 021-99241201-5 Ext 216/245 Fax 021-99241206
E.mail: [email protected]
1
(Reverse Blank)
PAKISTAN MARINE ACADEMY
APPLICATION FORM FOR ADMISSION IN 49TH BATCH
NAUTICAL AND ENGINEERING CADET
BSc (Martime Studies)-SESSION 2012-13
Paste Recent
Photograph
Official Use Only
Note:
Roll No: _______________________
1. This form is free of cost
2. This from contains six pages.
Academy No:
3. Read the instructions on page 1 carefully
4. Make all entries in BLOCK CAPITALS
5. This form can be downloaded from www.marineacademy.edu.pk
6. Photo copy of this form is also acceptable
1.
___________________
Name : ___________________________________ NIC # / Form B # :
( in full as in Matric Certificate / Equivalent )
2.
Fathers Name : ________________________________ Fathers NIC # :
(as on NIC )
3.
Postal Address : _____________________________________________________________________________
(for correspondance)
___________________________________________________City :____________________________________
E Mail :____________________Telephone # :____________________Mobile # :__________________________
4.
Date of Birth : _____date______month______year
5.
Domicile
6.
Marks Obtained in HSC/ Equivalent: a. Aggregate________ OUT OF_________
b. Maths _______OUT OF_______ c. Physics _______OUT OF________ d. Chemistry _______ OUT OF_________
d. Computer Science __________OUT OF_________
(as recorded in Matric Certificate or Equivalent) .
( Punjab, Sindh Urban, Sindh Rural, Baluchistan, Khyber Pukhtoonkhaw, Azad Kashmir, FATA/FANA) :__________________________
[ Indicate Subject marks out of 200. Candidates awaiting HSC result to indicate marks obtained out of 100 in HSC-I (First Year) /Equivalent].
7.
Choice of Branch (Nautical / Marine Engineering ) : Choice :__________________________________ ___________
(Candidates with Computer Science in HSC can opt for Nautical Branch only)
8.
Choice of Station for Medical Examination : First Choice :____________ Second Choice : _____________________
Muzzafarabad(AJK),
Multan
9.
Abbotabad ,
Bhawalpur
Peshawar,
PanuAquil
Kohat,
Quetta
Kharian
Islamabad
Hyderabad
Karachi
Sargodah
Lahore
Choice of Station for Entrance Test : First Choice:_________________Second Choice:_________________________
(Karachi , Islamabad , Peshawer , Sukkur , Quetta , Lahore )
10. Bank Draft/Pay Order # :________________________dated_________________________________
of___________________________Bank for Rs. 1500/-(Non-Refundable) is attached.
11. I declare that all information given above is correct to the best of my knowledge and belief and no information has
been concealed or misrepresented . I understand that my admission is liable to cancellation if any concealing or misrepresentation of facts is observed in this form at any time during or after my selection.
___________________
Signature Of Applicant
12. I have read all the information contained in the PMA Prospectus / Website regarding admission and training at Pakistan
Marine Academy for the 50th Batch of cadets . I have no objection for my son / ward to undergo this training scheme. I
further undertake to meet all financial liabilities of my son / ward for this purpose.
__________________
Sig of Father / Guardian
____________________
Signature of Witness
Name:__________________________
NIC # __________________________ (Attach photocopy)
2
(Reverse Blank)
Write your NAME and POSTAL ADDRESS (in full) in each of the four address slips below. These will be
used for correspondance /dispatch of Admit Card/Medical Letter etc. to you .
13.
Roll No: __________ ( leave this field blank)
Name: __________________________________________________________
Fathers Name: ___________________________________________________
Address: ________________________________________________________
______________________________________________________________________________________
_________________________________________________________________________________________________
City:
______________Tele No_____________________________________
Roll No: __________( leave this field blank)
Name: __________________________________________________________
Fathers Name: ___________________________________________________
Address: ________________________________________________________
______________________________________________________________________________________
_________________________________________________________________________________________________
City:
______________Tele No_____________________________________
Roll No: __________( leave this field blank)
Name: __________________________________________________________
Fathers Name: ___________________________________________________
Address: ________________________________________________________
______________________________________________________________________________________
_________________________________________________________________________________________________
City:
______________Tele No_____________________________________
Roll No: __________( leave this field blank)
Name: _________________________________________________________
Fathers Name: __________________________________________________
Address: _______________________________________________________
_____________________________________________________________________________________
________________________________________________________________________________________________
City:
______________Tele No____________________________________
3
(Reverse Blank)
PAKISTAN MARINE ACADEMY
ADMIT CARD FOR ENTRANCE TEST
50th Batch of Nautical/Marine Engineering Cadets
Academic Session 2012-2013
Paste Recent
Photograph
To be filled by Pakistan Marine Academy
Roll No: ________________
Date of Entrance Test: ____________________________ Time: ___________
Address of Entrance Test Centre: _____________________________________
1. Name:
___________________________ 2. NIC/Form B#:
3. Fathers Name: ______________________ 4. Fathers NIC#:
5. Postal Address: ___________________________________________________________________________
6. City: ________________________________ 7. Phone (Mobile)_________________________________________________________
8. Phone (PTCL)________________________________________ 9. Applicants Signature: ______________________________
Note :
1.Make all entries in BLOCK CAPITALS
2. Return both copies of Admit Card (duly filled) back to Pakistan Marine Academy by 10th August, 2011 along with Application Form
PAKISTAN MARINE ACADEMY
ADMIT CARD FOR ENTRANCE TEST
50th Batch of Nautical/Marine Engineering Cadets
Academic Session 2012-2013
Paste Recent
Photograph
To be filled by Pakistan Marine Academy
Roll No: _____________
Date of Entrance Test: _____________________ Time _________________
Address of Entrance Test Centre: ____________________________________
1. Name:
____________________________ 2. NIC/Form B#:
3. Fathers Name: _______________________ 4. Fathers NIC #:
5. Postal Address: ___________________________________________________________________________
6. City: ________________________________ 7. Phone (Mobile)_________________________________________________________
8. Phone (PTCL)________________________________________ 9. Applicants Signature: ______________________________
Note:
1
2
3
4.
Make all entries in BLOCK CAPITALS
Return both copies of Admit Card (duly filled) back to Pakistan Marine Academy by 10th August, 2011 along with application form
This copy of Admit Card will be posted back to you after verification and authentication by the Academy.
Bring this copy of Admit Card along with NIC / Form B (in original) OR F Sc/Equivalent Examination Admit Card to the
Examination Centre as proof of identity.
4
(Reverse Blank)
PAKISTAN MARINE ACADEMY
MEDICAL EXAMINATION REPORT
To Be Filled By Pakistan Marine Academy
Roll No:_______________
Batch No: 50th
Paste Recent
Photograph
Session : 2012-2013
Reporting Date ________________________________.
Medical Examination Centre ____________________________
1.
BIODATA
Name: _____________________________ NIC # /Form B: __________________________________
Fathers Name: ________________________ Fathers NIC #:__________________________________
Date of Birth: _____________________________
2.
PERSONAL HISTORY
Have you ever suffered from any of the following? (Tick YES/NO)
Disease/Disability
Yes
No
Disease/disability
Asthma/Breathlessness
Motion Sickness
Joint Pain
Broken Bone/Dislocation
Jaundice
Fits / Convulsion / Epilepsy
History of any operation including
laparoscopic operation
Head injury with unconsciousness
History of visual problems, Colour
Blindness, Night Blindness
Eye Surgery including Laser
Keratotomy And Corneoplasty
Earache / Ear Discharge
Tuberculosis/Pneumonia
Any Other Disease
Fever Headache/Migraine
Yes
No
3.
FAMILY HISTORY
Detail of immediate family members who have expired?
Relationship
Age on
Death
Detail of Disease Causing Death
Father
Mother
Brother
Sister
4.
I do hereby declare that the information given above is complete and correct to the best of my knowledge
and belief. I have not with-held any information. I am fully aware of the fact that by willful concealment of any of the
above information, may incur the risk of not being accepted for admission or termination from the training from
Pakistan Marine Academy.
___________________
(Signature of Candidate)
-------------------------------Signature of Witness
Name: __________________________
NIC # __________________________ (attach photocopy)
Address: ___________________________________
Note:
a.
b.
The paragraphs 1 to 3 are to be filled by the candidate.
Help from Paramedic or doctor if required can be taken
5
(Reverse Blank)
PAKISTAN MARINE ACADEMY
SUMMARY OF TRAINING CHARGES
FOR 50TH BATCH CADETS
a) PER SEMESTER CHARGES(in Rs)
S.NO.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
DESCRIPTION
Tuition Fees
Lodging Charges
Boarding Charges
Development Fund
Laundry Charges
Barber Charges
Stationery Charges
Examination Charges
Maintenance, Utilities &
Services Charges
Amenity Charges
Health Care
Uniform Charges
Total---------(a)
1st Semester 2nd Semester 3rd Semester 4th Semester
3,750
3,750
3,750
3,750
2,500
2,500
2,500
2,500
25,000
25,000
25,000
25,000
6,250
6,250
6,250
6,250
3,000
3,000
3,000
3,000
1,000
1,000
1,000
1,000
2,500
2,500
2,500
2,500
2,500
2,500
2,500
2,500
7,500
7,500
7,500
7,500
1,500
1,500
10,000
1,500
1,500
----
1,500
1,500
10,000
1,500
1,500
----
67,000
57,000
67,000
57,000
Rs.57,000
Rs.67,000
Rs.57,000
b) ONE TIME CHARGES(ON ADMISSION)
S.NO.
DESCRIPTION
1.
Admission Fee
2.
Caution Money(NonRefundable)
3.
Enrolment Fee &
Verification Charges
4.
Library, Subscription &
Transport Charges
5.
Security
Deposit(Refundable)
Total ------(b)
Grand Total (a + b)
5,000
2.000
3,000
1,000
5,000
16,000
Rs.83,000
Total training charges for two year course amount to Rs. 264,000/-(which will be charged in four
installments as mentioned above)
Note: 1.
In addition to the above the cadets shall have to arrange Rs. 12,000/- for
purchase of Text Books (once only at the time of joining the Academy).
2.
The Nautical Cadets shall have to pay Rs. 7,500/-(approx.) alongwith the
4th Semester Fee for Seamen Service Book.
6
(Reverse Blank)
