POLTEKPEL BANTEN
Toggle navigation
-
-
-
Entry Data Peserta Pelatihan Keterampilan
20 Mei 2022
DATA PESERTA
Nomor ID KTP / NIK
*
Nama Peserta
*
Tempat Lahir
*
Tanggal Lahir
*
Jenis Kelamin
*
LAKI-LAKI
PEREMPUAN
Nama Ibu Kandung
*
Pendidikan Terakhir
*
Agama
*
ISLAM
KATHOLIK
PROTESTAN
BUDHA
HINDU
KHONG HU CHU
Kewarganegaraan
*
WNI
WNA
Alamat Lengkap
*
No Handphone
Alamat E-mail
*
Program Diklat
*
BASIC SAFETY TRAINING ( BST )
PERSONAL SURVIVAL CRAFT RESCUE BOAT ( PSCRB )
MEDICAL FIRST AIDS ( MFA )
MEDICAL CARE ( MC )
ADVANCED FIRE FIGHTING ( AFF )
RADAR SIMULATOR ( RS )
ARPA SIMULATOR ( AS )
SECURITY AWARENESS TRAINING ( SAT )
SECURITY SHIP OFFICER ( SSO )
GENERAL OPERATION CERTIFICATE - GLOBAL MARITIME DISTRESS SAFETY SYSTEM ( GOC - GMDSS )
ELECTRONIC CHART DISPLAY INFORMATION SYSTEM ( ECDIS )
BRIDGE RESOURCE MANAGEMENT ( BRM )
ENGINE RESOURCE MANAGEMENT ( ERM )
CROWDED MANAGEMENT TRAINING ( CMT )
INTERNATIONAL SAFETY MANAGEMENT CODE ( ISM-CODE )
BASIC TRAINING OIL CHEMICAL TANKER ( BTOCT )
BASIC TRAINING LIQUID GAS TANKER ( BTLGT )
SECURITY TRAINING - SECURITY DESIGN SEAFARERS DUTIES ( SDSD )
CRISIS MANAGEMENT AND HUMAN BEHAVIOR TRAINING ( CMHBT )
FAST RESCUE BOAT ( FRB )
PASSENGER SAFETY, CARGO SAFETY AND HULL INTEGRITY ( PSCSHI )
ADVANCED OIL TANKER CARGO OPERATIONS ( AOTCO )
ADVANCE CHEMICAL TANKER ( ACT )
ADVANCE LIQUID GAS TANKER CARGO OPERATIONS ( ALGTCO )
TRAINING FOR MASTER AND OFFICERS IN CHARGE OF A NAVIGATIONAL WATCH ON BOARD OFFSHORE SUPPLY
ANCHOR HANDLING TUGBOAT SUPPLY ( AHTS )
INTERNATIONAL MARITIME DANGEROUS GOODS CODE ( IMDG CODE )
TRAINING OF OFFICERS AND RATINGS RESPONSIBLE FOR CARGO HANDLING ON SHIPS CARRYING DANGEROUS AND HAZA
BASIC SAFETY TRAINING ( BST ) KAPAL LAYAR MOTOR ( KLM )
HIGH SPEED CRAFT ( HSC ) BREVET A
HIGH SPEED CRAFT ( HSC ) BREVET B
FAMILIARIZATION HIGH SPEED CRAFT ( HSC )
REVALIDASI DIKLAT KETERAMPILAN PELAUT ( DKP )
CARGO CRANE OPERATOR
TALLYMAN OPERATOR
FORKLIFT OPERATOR
WELDING
ORU (OPERATOR RADIO UMUM)
Tanggal Diklat
*
PEMBERKASAN
(Berkas bertipe .jpg dan kapasitas max 2 Mb)
Fotocopy ijazah umum / sertifikat CoC
Browse...
Fotocopy akte kelahiran
Browse...
Fotocopy KTP atau Kartu Keluarga (KK)
Browse...
Sertifikat asli dan fotocopy warna sertifikat yang direvalidasi
Browse...
Fotocopy warna sertifikat BST
Browse...
Pas foto terbaru hitam putih dengan tulisan Poltekpel Banten ukuran 3x4 cm
Browse...
Surat keterangan tidak mampu (SKTM) dari Kelurahan/desa bagi peserta CSR/DPM
Browse...
Surat keterangan baca tulis dari Kelurahan/desa bagi peserta CSR/DPM
Browse...
Surat Pernyataan
Browse...
-=Download Surat Pernyataan=-
Surat keterangan sehat / sertifikat kesehatan yang masih berlaku
Browse...
Surat Masa Layar asli & fotocopy yang dikeluarkan oleh Syahbandar / Adpel**
Browse...
SKCK Asli dan fotocopy dari Kepolisian bagi peserta Rating Forming dan Able Seaferer
Browse...
Ket :
* Wajib Diisi
**untuk revalidasi TF ke BOCT atau BLGT, diklat Rating Forming atau Able Seafarer dan SCRB
