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Department of Transportation and Communications

PUNONGHIMPILAN TANOD BAYBAYIN NG PILIPINAS
(Headquarters Philippine Coast Guard)
139 25th Street, Port Area
1018 Manila

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APPLICATION FORM
PCG ENLISTMENT/COMMISSIONSHIP
Control Nr.

Coast Guard Officer Course - Commissionship

PERSONAL

Last Name

FAMILY

Middle Name

Permanent Address

Birthdate

Region

Birth Place

Contact Number (Cellphone /

Landline)

E DUCATION

Coast Guards Man Course - Enlistment

Given Name

Sex

Religion

Zip Code

Age

Civil Status

Height

Father's Name

Age

Occupation

Living/Deceased

Mother's Name

Age

Occupation

Living/Deceased

Parent's Mailing Address

Weight

Contact Number

Level

Inclusive Years
From
To

Name of School

Honors/Awards
Received

General
Average

High School
Vocational
College

Course:

Course:

I hereby certify that the above information are true and correct
Applicant's Signature

Examination Date / Time

Interviewer's Signature

---------------------------------------------------------------------------------------------------------------------------------Examination Permit
___________________________________________________________
(Last Name)
(First Name)
(Middle Name)
__________________________________
(Place 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

____________________
(Date of Exam)

Important Reminders:
1. Examinees must bring examination permit,
black ballpen & pencil on examination proper.
2. Applicants must be in casual attire and in proper
haircut.
3. Calculator & cellphone are not allowed during exam.