ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAK
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TRAINING COMPLETION AND RECORD OF ASSESSMENT REPORT
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Name of Maritime Training Institution:
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Training Course:Personal DataWritten Assessment Result (refer to *Grading Scheme)ASSESSMENT TASK (REFER TO ASSESSMENT PLAN)Practical Assessment Result (Refer **Grading Scheme)Result of the AssessmentTraining Certificate Number
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Class No.: (Regular) Training Duration:Date of Birth (mm/dd/yyyy)Place of BirthRankASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)ASSESSMENT CRITERIA (REFER TO ASSESSMENT PLAN)
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Class No.: (For re-sit) Training Duration:
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 Written: _______________PercentageRemarksCompetent [C]Not yet competent [NYC]
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 Practical: ______________
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Name of Trainee (Last Name, First Name, Middle Name):
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*Grading Scheme for Written Assessment: Obtained at least 75% of correct answers out of the total test items (as reflected in the ASSESSMENT PLAN)
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Certified Correct:
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PASS75% and Above
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FAILEDBelow 75%
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**Grading Scheme for Practical Assessment: Successfully meeting all the Assessment Criteria in all Assessment Tasks
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ASSESSORDateTRAINING DIRECTORDate
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Signature over Printed NameSignature over Printed NameLegendΓΌPerformed
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(MTI needs to indicate the validity of COA)XNot Performed
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