DECK CADET SELECTION – 2018

APPLICATION FORM
(To be filled in Block Letters)

This is a 2 page form. Please fill, print, scan and send the application form along with scanned copies
of the relevant documents as mentioned in item (2) at the end of the form by email to:
imtc.mumbai@wilhelmsen.com​.

Personal Data:
*Full Name (​Surname, First Name​)
Y A D A V B H A R A T
*Father’s/ Guardian’s Name
s u d a r s h a n k u m a r y a d a v
*Date of Birth​(dd/mm/yyyy) *Age ​(​as on 1st​ ​ May ’18​) *Sex
2 5 1 0 1 9 9 9 1 8 0 5 M
*Correspondence address ​(*​Pin Code is mandatory​)
h o u s e n o 1 5 6 6 s e c t o r 4

r e w a r i 1 2 3 4 0 1

(​mandatory​)
PIN CODE* 1 2 3 4 0 1
*Telephone No ​(​with STD Code​): *Mobile No.: +91
n o t a v a i l a b l e 9 9 9 1 3 5 3 3 8 1
*Email ID ​(​mandatory​):
s i d d h a r t h d v 7 7 @g m a i l . c o m
Father’s / Guardian’s Occupation

*Height in Cms *Weight in Kgs

1 7 8 6 6

*12​th​ Standard Board​ ​(​CBSE/ISC/HSC/…etc​): * Month/Year of passing/appeared ​(mm/yyyy)

c b s e 0 5 2 0 1 7

*Name of School/College and City

R P S R E WA R I R E WA R I

*12​th​ PCM % *12​th​ English % * 12​th​ Overall %

8 6 .3 3 7 8 0 0 8 3 .6 0

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 (If Results are awaited, fill ​“RA”​ in the above % boxes)

*10​th​ Standard Board​ ​(​CBSE/ICSE/SSC/etc…​): *Month/Year of passing 10​th​ Standard ​(mm/yyyy)

C B S E 0 5 2 0 1 5

*10​th​ Std English Marks *10​th​ Std Overall %

8 5 .5 0 8 1 .7 0

Are any of your relatives/friends serving in the Merchant Navy? If Yes, who? (​If relative – state relationship​)
Y MA T E R N A L U N C L E

Name of company where serving

M E D I T E R R A N E A N S H I P P I N G C O M P A N Y

Describe in your own words, why you are the right candidate for a career at sea:

I am a hard working student you can check that by comparing my 10th and 12th class marks. In 12th std.
my score in physics and maths were 95 and 88 respectively . I also have intermediate knowledge about
computers.I am not homesick also two of my family members are already in merchant navy so I know what
is expected of me in the job. I am physically fit and love to workout .

General Information:​ ​Extracurricular activities / other achievements

I started studying at RPS Rewari in 8th standard till my 12th std. but my school never encouraged any
extracurricular activity it was always about studying although I had hobbies which I did after school

__26.03.2018__ ___________________ ________________________

Date Signature of Candidate Signature of Parent/Guardian

Note​:

1. Please read the eligibility criteria & instructions carefully on our website:www.imtcmumbai.org
2. Attach scanned copies of the following documents only in pdf format:
● Marksheet copies of 12th ​ ​ Std (if results declared).
● Marksheet of 10​ Std.
th​

● Date of Birth Certificate

3. Do not send any original documents.
4. Scan your documents in PDF format only with a maximum size of 200 x 200 DPI.
5. Ensure you have filled all the (*) mandatory sections of the form.
6. Parents/Guardian must sign the application form.
7. To avoid rejection, please fill this form carefully.
8. Your application will be rejected if any false information has been provided.
9. Management Decision will be final for selection and location of Interview Centre.
10. It is mandatory to appear for the CET conducted by “Indian Maritime University” (IMU) around May 2018.
For further details visit IMU website: www.imu.edu.in

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