Department of Transportation and CommunicationsPUNONGHIMPILAN TANOD BAYBAYIN NG PILIPINAS

(Headquarters Philippine Coast Guard)139 25th Street, Port Area

1018 Manila

APPLICATION FORM

PCG ENLISTMENT/COMMISSIONSHIP

P E

R S

O N

A L

Control Nr. Coast Guard Officer Course - Commissionship Coast Guards Man Course - Enlistment

 

Last Name Given Name Middle Name

     

Permanent Address           Region

   Birthdate Birth Place Religion     Zip Code

         Contact Number (Cellphone / Landline) Sex Age Civil Status Height Weight

           

F A

M I

L Y

Father's Name Age Occupation Living/Deceased

       Mother's Name Age Occupation Living/Deceased

       

Parent's Mailing Address Contact Number

   

E D

U C

A T

I O

N Level Name of SchoolInclusive Years Honors/Awards

ReceivedGeneral AverageFrom To

High School          

VocationalCourse:

       

CollegeCourse:

       

I hereby certify that the above information are true and correct

Applicant's Signature Examination Date / Time Interviewer's Signature

     

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Examination Permit

___________________________________________________________(Last Name) (First Name) (Middle Name)

__________________________________ ____________________ (Place of Exam) (Date of Exam)

Initial Requirements:1. Transcript of Records/List of Grades authenticated by School (Xerox)2. College Diploma / Certificate from School (Xerox)3. Birth Certificate (Xerox)4. 2x2 Picture (2 pcs)Note: No requirements / Incomplete requirements – NO EXAM

Important Reminders:1. Examinees must bring examination permit, black ballpen & pencil on examination proper.2. Applicants must always wear jeans, white t-shirt

tucked-in, rubbershoes and in proper haircut.3. Calculator & cellphone are not allowed during

exam.