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F100 - Application form (DG approved Courses)
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Date of Birth
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Salutation
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Name
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Email id
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Mobile Number
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Alternate Mobile Number
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Address Line 1
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Address Line 2
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City
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State
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PIN Code
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Wish to join
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Blood Group
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Passport Number
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Aadhar number
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CDC Number
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COC Grade and Number
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Academic Qualification
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Current Rank
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Total Sailing Time ( in months)
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Mode of Payment Bank Details: ACADEMY OF MARITIME EDUCATION - TRAINING Kotak Mahindra Bank, Adyar Branch,Account Number - 04630010015186IFSC Code - KKBK0000463
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Preferred Course Start range of Dates between
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and
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Documents Sent by e-mail (ametdigital@gmail.com)
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Did you join in the e-learning of the course which you intend to join
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Remarks
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