First Name*

Middle Name*

Last Name*

Address*

Gender* Male Female

Date of Birth

Place of Birth*

Mobile Number

Rank/Position/Course*

Agency/Institution*

Address (Agency/Institution)*

School Last Attended

Email / Username*

Password

Confirm Password

Requirements - PSA Birth Certificate - BT Certificate - Drug Test - Valid Gov't-Issued ID Note: Required for Seafarers with COP in Basic Training issued before January 1, 2026

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