F-029

Issue 0 Revision 1
October 01, 2018
MARITIME ACADEMY OF ASIA AND THE PACIFIC
CENTER FOR ADVANCED MARITIME STUDIES
Associated Marine Officers' and Seamen's Union of the Philippines - PTGWO-ITF
Kamaya Point, Alas-asin, Mariveles, 2105 Bataan, Philippines

APPLICATION FOR STUDENT IDENTIFICATION CARD Recently taken

Passport Size Photo
This application shall not be acted upon unless the following information are received with Name Tag
(1 1/2” x 2”)
by the Admission Office of the Center for Advanced Maritime Studies, Maritime
Academy of Asia and the Pacific, Mariveles, Bataan. Computer generated
or photocopied
1. Correctly and completely accomplished Application for Student Identification picture
is not acceptable
Card.
2. One (1) recent 1 ½” x 2” Passport Size Photo with plain white background.
3. For signature: Please use 1.0 needle point pen.

ID Number
Needed Information Remarks
Complete Name (LN, FN, MD)

Academic Program

Maritime Rank

Date of Birth

Religion

Complete Address

Contact Number

Blood Type

SSS Number

HDMF Number

TIN

Philhealth Number

In Case of Emergency, pls. contact:

Student Signature: Please use 1.0 needle point pen.

I further affirm that all information supplied herein are
complete and accurate. I am aware that any or all of the
information furnished in this application may be checked
and that withholding or giving false information will
make me ineligible for student identification card.

Received by: Reviewed by: Approved by:

_______________________________ ___________________________ C/E RODOLFO D. PAISO, MSBM

Signature over Printed Name Dean, Center for Advanced Maritime Studies AVP for Post-Graduate/Executive Director
Date: ____________________ Date: _______________________ Date: _______________________