RLINS APPLICATION

1. Course Details

Course: ^*

2. Personal Details

First Name ^*

Middle Name

Last Name ^*

Gender ^*

Date of Birth ^*

Email ID ^*

Mobile Number ^*

Passport No.

(Passport) Date of Expiry

INDoS No. (if available)

CDC No. (if available)

Nationality

Religion

Community

3. Contact Information

Address

Address ^*

City ^*

Pin Code ^*

State ^*

Country ^*

4. Parents Details

Father's Name ^*

Father's Occupation

Father's Mobile Number ^*

Mother's Name ^*

Mother's Occupation

Mother's Mobile Number ^*

6. Academic Details

10^th Standard

Board ^*

Name of the School ^*

English Marks In Percentage^*

Total Percentage /CGPA ^*

Month & Year of Passing ^*

Medium of Instruction ^*

Passed in Single Attempt ^*

Yes

No

12^th Standard

Board

Name of the School/Institution

English Marks In Percentage

Total Percentage /CGPA

Month & Year of Passing

Medium of Instruction

Passed in Single Attempt

Yes

No

Details Of Diploma/Degree

Diploma/Degree ^*(Courses Should be from any Institute approved by State/Central-Government/AICTE)

Name of the College ^*

Name of the University ^*

Overall %/CGPA (up to pre-final/final Sem)^*

English Percentage ^*

Month & Year of Passing ^*

College Approved By AICTE ^*

Passed in Basic Safety Training(STCW) ^*

Yes

No

Education Details^*
Highest Education

Overall % / CGPA^*

COC Number ^*

COC Expiry Date ^*

Are You a Mariner?^*

8. How did you come to know about RLINS?

- Through -

Google Search

Newspaper

Relatives

RLINS Staff

Alumni

Online Application Form