Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Email address
Postcode
Qualifications held
Applicants must hold a STCW primary certificate of competency and certified copies of all relevant certificates must be provided
Name and contact details of issuing authority
Level of certificate Issue date STCW endorsment
(include fax or mail address)
Cert. 1
Cert. 2
Cert. 3
Short course details - certified copies of all short course certificates to be provided
Name of course Course provider Date completed
Declaration
WARNING: Personal information collection
Giving false or misleading information is a serious criminal offence. statement
To the best of my knowledge, the information given by me on this application is true and The Australian Maritime Safety Authority
(AMSA) is collecting the information on this
correct in every detail. form to assess your overseas qualifications
I have attached a certified copy of my current passport for the purposes of a migration application.
It will be used for purposes related to that
assessment, including the creation of a
Applicant’s signature Date Seafarer ID for future reference by yourself
/ /20 and AMSA, and treated in accordance with
the Australian Privacy Principles.
Please note: There is a assessment fee of A$472, payable to AMSA which must be paid This information may be exchanged
before this application can be processed. between AMSA and the Department of
Do not send cash with this application form via mail as this is an illegal action and there Immigration and Border Protection. Failure
is a high possibility of it being lost in transit. to provide the information may result in
the transaction not being processed. To
Send completed application, together with assessment fee to: contact us, or for more information on
Australian Maritime Safety Authority how to access or correct your personal
Shipping Qualifications information, how to make a privacy
GPO Box 2181 complaint, or how your information may
be used or disclosed, visit AMSA’s privacy
Canberra City ACT 2601
policy at www.amsa.gov.au/privacy/
AUSTRALIA