香港特別行政區政府海事處

MARINE DEPARTMENT
THE GOVERNMENT OF THE HONG KONG SPECIAL ADMINISTRATIVE REGION
高級海員 / 值班普通船員 / 電子技術普通船員
培訓合格證書申請表
Application for a Certificate of Proficiency as
Able Seafarer/Watch Rating/Electro-technical Rating
註：填寫本表格前，請參閱第 3 至 4 頁的「填表須知」及「收集個人資料聲明」。
Note: Please read the ‘Guidance Notes’ & ‘Personal Data Collection Statement’ on page 3 to 4 before filling in this form.

1 Personal Details 個人資料

Surname 姓 Given Name(s) in full 名

Chinese Name 中文姓名(if applicable 如適用) Sex 性別 Date of Birth 出生日期 Nationality 國籍
(DD 日/MM 月/YYYY年)

Telephone No. 電話號碼 Passport No. / H.K. Identity Card No. 護照或香港身分證號碼
(Home 住宅) (Mobile 手提)

Email 電郵 Seafarer’s Employment Registration Book No.海員僱用登記簿編號

Full postal address (for acknowledgement and return of your documents) 回郵地址（通知及寄回文件之用）
(Home 住宅)

Applied Certificate of Proficiency and Details of Relevant Training Courses 申請簽發的培訓合格證書及相關訓練詳情

 Courses Attended Name of Training Periods of Issue Date of
Institute Attendance Certificates
* 訓練課程 訓練學院名稱 訓練時間 證書簽發日期
Certificate for Junior General Purpose Ratings
初級全能海員證書
□ Elementary Pre-Sea Training
出海前知識初階
Basic Seamanship
Able Seafarer Deck
甲板高級海員

基本船藝
Navigational Watchkeeping Knowledge
航海值班知識
Proficiency in Survival Craft and Rescue Boats
救生船隻操作技能
Efficient Deck Hand
精練甲板人員
□ Elementary Pre-Sea Training
機房值班普通船員 導航值班普通船員 機房高級海員
Able Seafarer

出海前知識初階
Engine

Engine Room Watchkeeping Knowledge

機房值班知識
Basic Engineering knowledge
基本輪機知識
□ Elementary Pre-Sea Training
Watch Ratings
Navigational

出海前知識初階
Basic Seamanship
基本船藝
Navigational Watchkeeping Knowledge
航海值班知識
□
Elementary Pre-Sea Training
Watch Ratings
Engine Room

出海前知識初階

Engine Room Watchkeeping Knowledge

機房值班知識

□ Electro-technical Ratings 電子技術普通船員

* please tick () which you are applying 請在申請的項目欄上加剔號

MD693 (Rev. 2022/03) Page 1 of 4

Certificates of Proficiency Held 現時持有之培訓合格證書
Date of Issue Date of Expiry
Type Certificate No. Issuing Authority
類別 證書編號 發證機構 發證日期 有效日期
(DD 日/MM 月/YYYY年) (DD 日/MM 月/YYYY 年)

Sea Service during the Preceding Three Years 最近三年海上服務資歷的記錄

Port of Registry & Official Date 日期
Ship’s Name Number Officer Rank
船名
船籍港及正式編號
職級 From 由 To 至

2 Company Name and Address for Correspondence 公司名稱及通訊地址

Email 電郵: Fax 傳真: Tel 電話 :

3 Declaration 聲明書
I declare that 本人謹此聲明：－
(i) I have read the Notes appended to this application form carefully; and
我已細閱此申請書附載的備註；以及
(ii) the information and documents submitted herein and with this application form are full, true and complete to the best of
my knowledge and belief.
就我所知所信，所有填報於此申請書的資料及一併提交的文件均屬全面、真實及完整。
It is an offence under the Merchant Shipping (Seafarers) (Engine Room Watch Ratings) Regulation, the Merchant Shipping
(Seafarers) (Navigational Watch) Regulation and the Merchant Shipping (Seafarers) (Certificates of Proficiency for Able
Seafarers) Regulation to give false information.
根據商船（海員）（機房值班普通船員）規例、商船（海員）（導航值班）規例和商船（海員）（油船）規例，提交
不正確資料，實屬違法。

Signed by Applicant: Date:

申請人簽署： 日期：

For official use only 本處專用:

Result of application for issue of a CoP : Application Approved  Rejected 

Examiner: __________________________ Date: __________________________

MD693 (Rev. 2022/03) Page 2 of 4

 GUIDANCE NOTES 填表須知
Please read the following Notes before completing an application form 填寫培訓合格證書申請書時，請參閱以下的備註。
for issue of a certificate of proficiency.

General 一般事項

1. The form should be completed in English (block letters) as far as 1. 請盡可能用英文正楷填寫此申請書。

practicable.
2. 申請人必須提供所需資料。請確保申請書各部
2. The supply of information is obligatory. Please ensure that all
parts in the form are completed and the information provided is 分均已填妥，且所填資料均正確無誤，以免申
accurate. Failure to do so may result in unsuccessful application. 請不獲處理。

3. Applications may be submitted in person or by post/email 3. 申 請 書 可 親 身 遞 交 或 郵 寄 / 電 郵

(ebs_crt@mardep.,gov.hk) to the Seagoing Examination and (ebs_crt@mardep.,gov.hk) 至海事處遠洋航行
Mercantile Marine Office, Marine Department, Room 302, 3rd 考試及商船海員管理處（地址：香港中環統一
Floor, Harbour Building, 38 Pier Road, Hong Kong. Please 碼頭道 38 號海港政府大樓 3 樓 302 室）。如
contact this administration by (852)-2852 3148 for any enquiry.
欲查詢，請聯絡本處，電話： (852) 2852 3148。

Fee 收費
4. Certificate of Proficiency is issued free of charge. 4. 簽發培訓合格證書費用全免。

Approved training courses 認可訓練課程

5. Course completion certificates must be issued and signed by a 5. 修畢相關的認可訓練課程證書，必須由認可

responsible official of the approved training institution. 訓練機構的有關官員簽發。

Documents to be submitted 須提交文件

6. Applicant should submit the original of a completed application 6. 申請人須提交填妥的申請表正本及以下文件

form together with the following documents, if applicable: （如適用）
(a) proof of identity (Hong Kong Identity Card or Passport)
(a) 身份證明文件（香港身份證或護照）
(b) Discharge Book / Seafarer Employment Registration Book;
(b) 辭職證書 / 海員僱用登記簿
(c) medical fitness certificate;
(c) 健康證明書
(d) certificate of relevant training course approved by the
Director of Marine; (d) 海事處處長認可訓練課程證書；
(e) Training Record Book; and (e) 訓練記錄簿；及
(f) two passport size photos. (f) 護照照片尺寸的近照兩張。
(Note: For items (a) to (f), a legible copy certified by a （備註： (a)至(f) 項文件正本，可由影印副本
responsible public official, or the employer as true copy can be
替代。該等影印副本應清晰可閱並須由一位適
accepted in lieu of the original.)
當的公職人員，或僱主核實。）

Recognition of Certificates Issued by Other Administrations 承認由其他主管機關發出的培訓合格證書

7. Seafarers holding Certificates of Proficiency issued pursuant to 7. 船員持有《STCW 公約》締約國根據《STCW
Chapter V and Chapter VI of the Annex to STCW Convention by, 公約》附則第 V 章和第 VI 章發出的，或是在
or under the authority of, the government of a state party to the
其授權下發出的培訓合格證書，本處接受具
STCW Convention. This Administration accepts those
certificates issued by STCW Convention parties to have the same 同等效力，船員不需另行申請由本處簽發的
effect as those issued by Hong Kong. These seafarers do not 培訓合格證書。
need to apply for a Certificate of Proficiency issued by this
Administration.

MD693 (Rev. 2022/03) Page 3 of 4

 Personal Data Collection Statement 收集個人資料聲明

1. Purposes of Collection
1. 收集目的
The personal data provided by means of this form will be used
海事處會使用透過本申請表所獲得的個人資料
by Marine Department for the following purposes:
作下列用途：
(a) activities relating to the processing of your application in this
(a) 辦理有關審批你在本申請表中所提出的申
form;
請的事務；
(b) facilitating communication between Marine Department and
yourself; (b) 方便海事處與你聯絡；
(c) assisting in the enforcement of any other Ordinances and (c) 藉此協助其他政府決策局和部門執行其他
Regulations by other Government Bureaux and 法例和規例；
Departments; (d) 成功申請人的有限個人資料會用於海事處
(d) limited personal data of successful applicants may be used 的互聯網網頁以供第三者查證本處所發出
via the Marine Department’s Internet web site for 的證書；
verification of the issued certificate by any third party; (e) 供作統計及研究用途，但所得的統計數字或
(e) for statistics and research purposes on the condition that the 研究成果，不會以能辨識各有關的資料當事
resulting statistics or results will not be made available in a 人或其中任何人的身份的形式提供；以及
form which will identify the data subjects; and
2. 獲轉交資料的部門╱人士
2. Classes of Transferees 你透過本申請表所提供的個人資料會向其他政
The personal data you provided by means of this form may be 府部門、決策局及有關機構，以作上述第 1 段
disclosed to other Government Bureaux and Departments for the 所列的用途。
purposes mentioned in paragraph 1 above.
3. 索閱個人資料
3. Access to Personal Data 根據《個人資料 (私隱) 條例》第 18 及 22 條
You have a right of access and correction with respect to 及附表 1 第 6 條，你有權索閱及修正你的個人
personal data as provided for in Sections 18 and 22 and Principle 資料。你的索閱權包括獲取本申請表所提供的
6 of Schedule 1 of the Personal Data (Privacy) Ordinance. 個人資料副本一份。
Your right of access includes the right to obtain a copy of your
personal data provided by this form.
4. 查詢
4. Enquires 有關透過本申請表收集的個人資料的查詢，包
Enquiries concerning the personal data collected by means of 括索閱及修正資料，應寄往：
this form, including the making of access and correction, should
be addressed to: 香港
Officer-in-charge 中環統一碼道 38 號
Seagoing Examination and Mercantile Marine Office 海港政府大樓 3 樓 302 室
Marine Department 遠洋航行考試及商船海員管理處主管
Room 302, 3/F, Harbour Building
38 Pier Road, Central
Hong Kong

MD693 (Rev. 2022/03) Page 4 of 4