CoA FORM NO. 1 rrc_11July2011

APPLICATION FEE IS P350.00 (NON-REFUNDABLE)

APPLICATION FORM (READ THE GUIDELINES AT THE BACK BEFORE FILLING-IN THIS FORM)

Last Name (Write Legibly in BOLD LETTERS)

First Name

Middle Name

COMPLETE MAILING ADDRESS:

(No.) (Street/Barangay) (Town/City) (Province) (Region) (Zip Code)

CONTACT NUMBERS: Mobile1: ________________ Mobile2: ________________

Home: ____ ____________ Email: _________________ Area Code Telephone Number

DATE OF BIRTH: ____/____/________ AGE: _______

DD MM YYYY GENDER: _____ WEIGHT: ____(kgs) HEIGHT: _____(ft) FATHER’S NAME:

________________________________________________ MOTHER’S NAME:

________________________________________________ GUARDIAN’S NAME:

________________________________________________ HIGHEST EDUCATIONAL ATTAINMENT:

________________________________________________ NAME AND ADDRESS OF SCHOOL:

________________________________________________

Application Filing Options: Personal Walk-in Mail

____________________________________ APPLICANT’S SIGNATURE

For Committee on Admissions use only

Permit No.: _______________________ O.R. No.: _______________________

CODE TESTING CENTERS

01 PMMA, ZAMBALES Philippine Merchant Marine Academy, San Narciso

02 NCR, CUBAO Ramon Magsaysay High School, Edsa

03 NCR, FAIRVIEW Batasan Hills National High School

04 ALBAY Tabaco National High School, Tabaco City

05 AURORA Aurora State College of Technology, Baler, Aurora

06 BATANGAS Batangas National High School, Batangas City

07 BENGUET Baguio City National High School

08 BOHOL Dr. Cecilio Putong National HS, Tagbilaran City

09 BULACAN Marcelo H. Del Pilar National High School, Malolos City

10 CAGAYAN Cagayan National High School, Tuguegarao

11 CAMARINES SUR Camarines Sur National School, Naga City

12 CAVITE Bacoor National High School

15 IFUGAO Ifugao State University of Agriculture & Forestry, Nayon, Lamut

16 ILOCOS NORTE Ilocos Norte National High School, Laoag City

17 ILOILO CITY Iloilo National High School, Lapaz

18 ISABELA Rizal National High School, Santiago City

19 LA UNION La Union National High School, San Fernando

20 SAN PEDRO, LAGUNA Pacita Complex National High School

21 STA CRUZ, LAGUNA Pedro Guevarra Memorial National High School

23 MISAMIS ORIENTAL Misamis Oriental Gen. Comp. HS, Cagayan de Oro

24 MT. PROVINCE Mt. Province Gen. Comp. HS, Bontoc

25 NUEVA VIZCAYA Solano High School, Solano

26 PALAWAN Palawan National School, Puerto Princesa City

27 PAMPANGA Pampanga High School, San Fernando

28 PANGASINAN Dagupan City National High School

29 QUEZON PROVINCE Quezon National High School, Lucena City

30 SOUTH COTABATO Gen. San. City High School-Main, Calumpang

31 SOUTHERN LEYTE St. Anthony High School, Anahawan

32 TARLAC Tarlac National High School, Tarlac

33 ZAMBOANGA CITY Zamboanga City State Polytechnic College, R.T. Lim Blvd.

TESTING CENTER CODE (Fill-up with the Code of your preferred Testing Center)

Affix 2x2 ID Photo

with nameplate here

Mail Application Forms to the:

Chairman Committee on Admissions

Philippine Merchant Marine Academy San Narciso, Zambales

Tel. No. (047) 913-2239

NOT LATER THAN AUGUST 31.

Be a Merchant Marine and Naval Officer

Travel the World for Free

The PMMA Entrance Examination is conducted on the LAST SATURDAY of SEPTEMBER every year.

CoA FORM NO. 1 rrc_11July2011

P M M A A D M I S S I O N S C A L E N D A R

JUN JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY

SUBMISSION OF APPLICATION FORMS

EXA

M SUBMISSION OF APPLICATION FORMS

Personal Mailed

Wait for permit or call 047-9132239

Call 047-9132239 Visit www.pmma.edu.ph

DO NOT WAIT FOR MAILED NOTICE PSYCH TEST Call 047-

9132239 for results

MEDICAL Call the Medical Unit at 047-9134396 for results

ONE-MONTH ORIENTATION

TRAINING

NOTE: In order for a Testing Center to be opened, a MINIMUM number of 50 applicants is needed. In case the number of applicants is less than 50, those applicants will then be reassigned to another testing center nearest to the applicant’s preferred testing center.

QUALIFICATION REQUIREMENTS Applicant should/must be:

Male or female, physically fit, natural born Filipino citizen;

Single and never been married and has no children out of wedlock;

Free from being accused or convicted of any crime against the law and the state;

Not a day younger than 16 years old or a day older than 22 years old upon admission by June;

At least high school graduate qualified to enroll in a four year course or graduating from high school on April of next year;

At least 160 centimeters (5 ft. & 3 in.) weighs 55 kgs. (120 lbs.) stripped for male and 155 centimeters (5 ft. & 1 in.) weighs 50 kgs. (110 lbs.) stripped for female;

At least average academic performance and preferably has taken Trigonometry in High School;

Has never been enrolled in PMMA.

GROUNDS FOR MEDICAL DISQUALIFICATION Defective Visual Perception (color blindness, near sighted/far

sighted with corrective eyeglasses or lens);

Physical Deformities (bowlegged) congenital defects;

Perforated ear drum, chronic sinusitis, bleeding tendencies, hemorrhoids, hernia (if not treated), varicocoele, extensive skin disorders;

History of heart disease, hypertension, asthma, active PTB, kidney and liver diseases, epileptic seizure disorders, major operations, communicable diseases (such as AIDS, Hepatitis, VD, etc.);

Full dentures, upper and lower; Cleft lip and palate, Malocclusion, Deformities of the face, Open bite, Tongue-tied; Missing of four anterior or front teeth & Missing of four posterior/molar teeth;

Tattoos and other brotherhood marks;

Additional for Females: Goiter, History of pregnancy, presence of breast mass, painful menstruation.

The courses being offered in PMMA are:

Bachelor of Science in Marine Transportation Bachelor of Science in Marine Engineering

PROCEDURE

1. This Application Form can be photocopied. 2. Only true and correct entries on this form are accepted; any false information will be a ground for your disqualification. 3. Write the code number in the testing center code box after selecting your preferred examination center from the table of Testing

Centers. 4. SUBMISSION of APPLICATION FORMS :

Applicants have 2 options to file the Application Form:

Personal – From June to September @ PMMA Zambales only

Mail – From January to first week of September only

5. FILING REQUIREMENTS:

3 copies of recent 2x2 colored pictures with nameplate, front view; white background

Examination fee of three hundred fifty pesos (P350.00) in cash or postal money order payable to the PMMA Committee on Admissions (if application is filed through mail, only postal money order will be accepted);

Certified true copy of Birth Certificate issued by the Civil Registrar; (Photocopy only) Note: Baptismal and Hospital Birth Certificates are not honored.

2 pcs. Self-addressed long white mailing envelopes with P30 worth of mailing stamps per envelope

6. EXAM: The PMMA entrance examination covers the following subjects/ areas: English, High school Mathematics (Algebra, Geometry and Trigonometry), Science (Gen. Science, Chemistry & Physics), Abstract Reasoning

7. NEURO-PSYCHOLOGICAL EVALUATION

8. MEDICAL: Successful examinees of the Entrance Examination still have to undergo the following to qualify for admission: 8.1 Pre-Medical: Height/Weight, Color Perception Test (ISHIHARA), Snellens, Pre-Dental 8.2 Laboratory Examinations 8.3 Physical Examination

9. ONE-MONTH ORIENTATION TRAINING

Application Forms are also available at: All Testing Centers and PMMA Website - www.pmma.edu.ph

The Application Form should be duly accomplished by the applicant and submit or mail it to the Committee on Admissions together with the Filing Requirements. Application forms with incomplete requirements will not be processed.

JUAN C. DELA CRUZ #98 Scout Castor St. Brgy. Pag-asa, Project 6 1100 Quezon City

THE CHAIRMAN Committee on Admissions

Philippine Merchant Marine Academy San Narciso 2205 Zambales