MSF 4274 REV 07/24

MD
APPLICATION FOR AN ORAL EXAMINATION LEADING TO THE ISSUE OF A
CERTIFICATE OF COMPETENCY (STCW) FOR MASTERS, CHIEF MATES &
DECK OFFICERS IN THE MERCHANT NAVY

IMPORTANT - BEFORE completing this form, please ensure you have read the guidance notes and instructions on
pages 8 to 13.

If this is your first UK CoC application, please post your Training Record Book (TRB) only to;

UK Seafarer Services (Training & Certification), Maritime and Coastguard Agency, Spring Place, 105
Commercial Road, Southampton SO15 1EG, UNITED KINGDOM

For all applicants, please email your application and scanned documents to deck@mcga.gov.uk
please note you may be selected for random screening, which will require you to post original documents to us
(as per MIN 655).

ALL FIELDS IN SHADE ARE MANDATORY

1 PERSONAL DETAILS

Title (Mr/Mrs/Miss/Capt etc.) MR Sex (Male/Female) MALE

Surname / Family name
Forename(s) in full RANDHIR SINGH
Date of Birth (DD/MM/YYYY) 15/01/1991
Place of Birth CHANG, HARYANA Country of Birth INDIA
Nationality INDIAN
Home Address (Residency)
Address HOUSE NO. 1298, CHANG
District BHIWANI
Town / City BHIWANI
County/State HARYANA
Post Code/Zip 127027
Country INDIA
Email dr.rst28@gmail.com
Mobile Tel. No. +91 9350238349

If delivery address for your documents/licence is different to your Home Address above then add below

Address
District
Town / City
County/State
Post Code/Zip
Country

Please click the checkbox if your return address is located within the Isle of Man, Isle of Scilly, the
Highlands or Islands of Scotland (not including Aberdeen)

Sponsoring Company Email, for UK Cadets only;

we will copy your company in, if we request further Company Email:
documentation and when we issue your NOE:

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 2 CERTIFICATE APPLIED FOR

Capacity STCW Reg. Tonnage Limits (GT) Limitations

OOW II/3 Less than 500 GT Near Coastal
OOW II/3 Less than 500 GT Category “D” Waters
OOW II/1 None None ✔
Chief Mate II/2 Less than 3000 GT Near Coastal
Chief Mate II/2 Less than 3000 GT None
Chief Mate II/2 None Near Coastal
Chief Mate II/2 None None
Master II/3 Less than 500 GT Near Coastal
Master II/3 Less than 500 GT Category “D” Waters
Master II/2 Less than 3000 GT Specified Area, Domestic Vessels Only
Master II/2 Less than 3000 GT None
Master II/2 None Near Coastal
Master II/2 None None

Please do NOT write below this line

Received Date: Documents: SDS No:

RMS No:

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 MD
3 SEA SERVICE take details from your Discharge Book or Certificates of Discharge

Please refer to the flow chart on page 13 for the new sea service requirements. If you are using yacht service you must complete the table on page 9.

Those obtaining seagoing service on Tugs towards a Chief Mate or Master unlimited area CoC should email exams@mcga.gov.uk prior to applying. The MCA will need to
assess your seagoing service to ensure it meets the requirements for the issue of an unlimited area CoC.

Deck Officers – this means service on crew agreement as a Deck Officer. The sea service must be supported by testimonials which include watchkeeping time, which must be
signed by the Master. Please refer to guidance notes (3) on page 8 for the requirements.
ALL RELEVANT SEA SERVICE MUST BE LISTED. If there is insufficient space, please continue on a separate sheet. Sea service on foreign flag ships will be accepted under
the same conditions as service on UK ships provided it can be properly verified.
LENGTH OF VOYAGE: this must be given in calendar months and days, e.g. from 3 January to 5 March = 2 months and 3 days. Odd days should be added together and
reckoned at 30 days to the month.

SHIP AND VOYAGE DETAILS DATES (DD/MM/YYYY) DURATION

Vessel Name Official Number Flag GT Type * Voyage ** Rank/Capacity From To Months Days
MAERSK TUKANG 9334686 SINGAPORE 94055 CONTAINER UNLIMITED ABLE SEAMAN 20/06/2024 07/03/2025 08 18
RHONE MAERSK 9457000 DENMARK 50885 CONTAINER UNLIMITED ABLE SEAMAN 08/10/2023 10/03/2024 5 03
MAERSK HALIFAX 9784271 SINGAPORE 153744 CONTAINER UNLIMITED ABLE SEAMAN 14/12/2022 06/07/2023 6 24
MAERSK HALIFAX 9784271 SINGAPORE 153744 CONTAINER UNLIMITED ORDINARY SEAMAN 24/09/2022 13/12/2022 02 20
JEPPESEN MAERSK 9215165 DENMARK 30166 CONTAINER UNLIMITED ORDINARY SEAMAN 16/02/2022 26/07/2022 05 11
MAERSK SENANG 9315240 SINGAPORE 79702 CONTAINER UNLIMITED ORDINARY SEAMAN 09/08/2020 18/06/2021 10 10

Total 38 26

* Type – you should state whether: Tanker, Cargo, Passenger, Ro-Ro, Supply, Tug, Drilling, Survey, Stand-by, Yacht etc – if Yacht please provide vessel length in metres
** Voyage - you should give the area in which the ship traded using the following codes; U = Unlimited, NC = Near Coastal Area

3
 4 CHECKLISTS Before a Notice of Eligibility can be issued, you will need to submit the
following documentation digitally by attaching to your application email

If you already hold a Certificate of Competency (CoC) or Certificate of Service you must email it in with this
application and give the following details below
Certificate No: Capacity: Country of Issue:

4 A FOR ALL APPLICATIONS Please Official

mark () use
only

Payment – Please see section 7 ✔

Scan of Passport and Visa if applicable (Please refer to guidance notes) ✔
Scan of relevant Discharge Book pages OR Certificates of Discharge ✔
Scan of Sea Service Testimonials which include watchkeeping evidence ✔
Passport style photograph (please refer to guidance notes) ✔
Scan of Valid Medical Fitness Certificate *
(DG Shipping India medicals must include ‘Annexure IV – Medical Certificate for Service at Sea’ page) ✔

* To comply with health and safety requirements in accordance with the Merchant Shipping Training & Certification (Medical Examination) Regulations
2002 and STCW Regulation I/9, any seafarer employed or engaged in any capacity aboard a seagoing Vessel must hold a valid medical fitness
certificate attesting to their medical fitness for the work for which they are employed. If you are unable to take a solo watch of not fit for lookout
duties you will not be issued with a UK Deck Officer CoC. Medical Fitness Certificates must be valid at the time of issue of the CoC. This
should be re-submitted with your NOE pass.

For a list of MCA approved doctors please visit our website: www.gov.uk and search “MCA approved doctors”.

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4 B APPLICATIONS FOR FIRST CERTIFICATE Please
Official
Use
Mark () Only

Candidates following the Foundation Degree OR HNC OR Alternative Route and claiming reduced sea
service must provide a digital letter from their college confirming the route being undertaken – template in
MIN 563
Scan of STCW – Full course Elementary First Aid (STCW A-VI/1-3) ✔
Scan of STCW – Full course Fire Prevention and Fire Fighting (STCW A-VI/1-2) ✔
Scan of STCW – Full course Personal Survival Techniques (STCW A-VI/1-1) ✔
Scan of STCW – Full course Personal Safety and Social Responsibilities (STCW A-VI/1-4) ✔
MNTB approved Training Record Book for candidates claiming reduced sea service*

* Please ensure the following is completed when submitting your MNTB Training Record Book.

An incomplete MNTB can lead to your application taking longer to process or not being approved:

a) Complete all contact details;

b) Ensure that your Designated Shipboard Training Officer (DSTO) has inspected your work and signed to confirm this;
c) All tasks are completed and the appointed supervisor has signed off against them.

The hard original Training Record Book (TRB) must be sent to our office and not scanned to your application
email. Please ensure you add your name, date of birth and address to a piece of paper attached to your TRB before
posting to us so we can ensure it is paired with the correct application form you have emailed to us.

Before your CoC can be issued you will be required to submit further documentary evidence of training as per
MSN 1856 Amendment 1. These documents are not required for the issue of your NOE, however you may wish to
submit these now. Please refer to section 5 of the Guidance Notes. The documents will be requested on your NOE.

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 5 DECLARATION (The maximum penalty for a false declaration is £5000)

I declare that the data contained in this application is, to the best of my knowledge, true and complete. I also declare that
the documents are genuine, given and signed by the persons whose names appear on them. I consent to any processing
of the data contained in this application by the MCA (including any processing necessary to establish the authenticity and
validity of the issued certificate). Please refer to our privacy statement in the guidance notes which explains how we use
the personal information we collect from you.

DECLARATION: Enter your name RANDHIR SINGH For office use only

Today’s date (DD/MM/YYYY): 31/03/2025

• Please email this digital application form to deck@mcga.gov.uk

• Please also attach in your email the scans/photos of the required documentation from Section 4
• Please attach your passport photo as per Photo Form1 instructions
• Please attach the required specimen signatures on Form Signatures1

Please ensure payment has been made and all required documents have been provided. If your
application is missing relevant documents or payment, your application will be delayed and
may not be assessed.

6 COUNTER DECLARATION

You should obtain a counter declaration from a responsible person who is NOT related to you and has known you for at least
2 years. They should enter their details in this section. We may contact this person by email to validate the declaration.

Name CRYSTEL LADIA

Address SHELTON SAPPHIRE, A-303, PLOT NO. 18&19, SECTOR 15 , CBD BELAPUR
Town / City CBD BELAPUR, NAVI MUMBAI
County/State MAHARASHTRA

Post Code/Zip 400614

Country INDIA
Email address crystel. ladia@smeindia.org.in
Telephone No +91 9082405377
Capacity in which you know the applicant STUDENT
Occupation SERVICE

I declare that the information given is, to the best of my knowledge, true and complete. I also declare that the documents
submitted are, to the best of my knowledge, genuine and relate to the person(s) whose names appear on them. I confirm
that the photograph submitted bear a true current likeness of the applicant and I am willing to confirm by email if I am
contacted by the Maritime & Coastguard Agency.

DECLARATION: Enter your name CRYSTEL LADIA

Today’s date (DD/MM/YYYY): 31/03/2025

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 7 PAYMENT

IMPORTANT NOTE: If you are sending documents from outside the UK and indicate to your courier company that the
documents have a value of over £100 GBP, you will be liable to pay any import charges.

You must ensure you pay the appropriate fee (as laid down in the current Merchant Shipping Fees Regulations)

Payment should be made in pounds sterling (£), by BACS transfer, credit or debit card via online payment facility Gov.uk
Pay by following the links below.

We are unable to accept cheques, postal orders, banker’s drafts or cash.

The fee for an NoE application is £220 which includes the cost of a courier service.
The fee for an upgrade with no oral examination is £77*. Postage to the UK is an additional £10, postage to Europe is an
additional £20 and postage to the rest of the world is an additional £30.

The fee for a combined Master <500 GT near-coastal and Master <3,000 GT Specified Area CoC is £379**. Please check (x)
the appropriate box below to indicate your chosen method of payment.

Notice of Eligibility Applications

✔ To pay via Gov.UK Pay for your Notice of Eligibility: £220

https://www.gov.uk/payments/seafarer-training-courses/application-for-deck-merchant-certificate-of-competency-including-upgrades

Combined Notice of Eligibility Applications

To pay via Gov.UK Pay for your Notice of Eligibility: £379

https://www.gov.uk/payments/seafarer-training-courses/application-for-combined-master-less-than-500gt-near-coastal-
and-master- less-than-3000gt-specified-area-coc

UK Certificate of Competency Upgrade Applications without Oral Examination.

To pay via Gov.UK Pay for delivery to the UK: £87

https://www.gov.uk/payments/seafarer-training-courses/application-for-deck-merchant-certificate-of-competency-
including- upgrades-uk-upgrade

To pay via Gov.UK Pay for delivery to the European Union or EEA: £97
https://www.gov.uk/payments/seafarer-training-courses/application-for-deck-merchant-certificate-of-competency-
including- upgrades-eu-upgrade

To pay via Gov.UK Pay for delivery to the Rest of the World: £107
https://www.gov.uk/payments/seafarer-training-courses/application-for-deck-merchant-certificate-of-competency-
including- upgrades-row-upgrade

If you wish to pay by BACS transfer – please email seafarer.finance@mcga.gov.uk for our bank details.

* The upgrade that does not require an oral examination (£77) is: Master less than 3000 GT unlimited area
from Chief Mate unlimited (Please note that the Master unlimited GT, near coastal endorsement now requires a
separate oral examination (£220).

**You may apply for these Certificates of Competency at the same time, however you must meet all the requirements for
the issue of a Master <500 GT near-coastal prior to being issued a Master, less than 3,000 GT, specified trading area
NoE.

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GUIDANCE NOTES FOR THE COMPLETION OF THIS APPLICATION FORM MD

PLEASE ENSURE THAT YOU READ AND UNDERSTAND THESE NOTES BEFORE COMPLETING THE FORM. YOU
SHOULD ALSO REFER TO GUIDANCE FORM MSN 1856 Amendment 1.

Please complete this form digitally when possible, otherwise complete in black ink, scan/photograph and email to
deck@mcga.gov.uk

ENSURE YOU COMPLETE THIS FORM IN FULL - FAILURE TO DO SO MAY MEAN THAT WE WILL HAVE TO RETURN
YOUR APPLICATION TO YOU, AND WILL RESULT IN A DELAY TO YOUR APPLICATION BEING PROCESSED.

Enclose all documents necessary to establish your eligibility for examination for an STCW Certificate of Competency. A
document checklist is on pages 4 & 5 to help you.

If eligible you will be issued with a Notice of Eligibility (NoE) enabling you to sit an MCA oral examination. The NoE will be
valid for 5 years from the date of issue. The NoE will advise you how to apply for an appointment for the examination and
what you should do once you have taken the examination. Oral examination passes for each level of certification are valid for
three years from the date of the oral exam.

The oral examination pass must be in date at the time of issue of the CoC.

A series of Training and Certification Guidance Notes, giving further details of requirements are available from the Seafarer
Training & Certification Branch, the contact details are below, or they can be found on our website www.gov.uk/mca.

1 PERSONAL DETAILS

Enter your personal details in the boxes provided. Your name should be given IN FULL, and should be given in the same
format as appears in your passport or birth certificate.

Your date of birth should be given in the format DD/MM/YYYY. You should give your permanent home address, where
you are normally resident.

You may also provide an alternative address for return of documents or correspondence relating to this application, e.g. if
you are away at college.

2 CERTIFICATE APPLIED FOR

Please check (x) the capacity / limitations for which you are applying. Only tick ONE box.

3 SEA SERVICE

All sea service submitted on page 3 of the application form must be supported by a Discharge Book OR Certificates of
Discharge AND Sea Service Testimonials which include watchkeeping evidence. A pro forma for the Sea Service Testimonial
can be found in MSN 1856 Amendment 1. Acceptable testimonials must be signed, stamped and dated by the Master OR
other responsible company representative.

Below is the required sea service for the different MCA approved routes:

Officer of the Watch:

• Examination: 36 months with 6 months bridge watchkeeping
• Foundation Degree: 12 months with 6 months bridge watchkeeping
• HNC/HND (With an MNTB Training Record Book) : 12 months with 6 months bridge watchkeeping
• AMET: 15 months with 6 months bridge watchkeeping
• If you are following an MCA approved overseas collaborative programme (so called one plus one schemes) you should
consult with the UK parent college as agreements will be made with the MCA on a programme by programme basis.

Chief Mate: 12 months as a Deck Officer since obtaining your OOW CoC.

For upgrades to Chief Mate <3000 GT unlimited area: 6 months watchkeeping sea service. This will include an oral
examination (£220). For all other upgrades please refer to the diagram on page 4 of MSN 1856 Amendment 1.

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Master: 36 months as Deck Officer since qualifying as an OOW or 12 months whilst holding a Chief Mate CoC and sailing as
Chief Mate.

For upgrades to Master <3000GT unlimited area: at least 12 months serving as Chief Mate or 36 months as Deck Officer
since qualifying for an OOW unlimited. For all other upgrades please refer to MSN 1856 Amendment 1. This does not
require an oral examination (£76).

4 CHECKLISTS

Before a Notice of Eligibility (NOE) can be issued ALL the documents in this section MUST be provided with this application.
Please ensure you check (x) each box to indicate that you have enclosed the documents. If you are applying to upgrade or
add an endorsement to your Certificate of Competency (CoC) you must hold the applicable MCA-issued Certificate of
Competency prior to making your application. The required CoCs are listed in MSN 1856 Amendment 1. Non UK CoC holders
will need to convert their CoC to a UK CoC as per section 14 of MSN 1856 Amendment 1.

Any candidate failing to submit all the required documents may have their application returned without being processed.

Photographs

Please attach your passport photo as per separate Photo Form1 instructions

Medical Fitness Certificates

All candidates for any CoC must provide a valid medical fitness certificate, either

• The UK medical fitness certificate, currently known as an ENG 1, issued by an MCA approved medical practitioner, or
• A certificate issued by the Administration of any country whose medical fitness certificate is recognised as equivalent to the
UK ENG 1

Medical Fitness Certificates must be valid at the time of issue of the CoC.

Further Evidence of Training required before your CoC can be issued

The following documentary evidence will need to be provided before your CoC can be issued, however it is not required for the
issue of your NOE.

For All Applicants:

If any of the 4 below certificates are over 5 years old you will be required to provide evidence of the relevant updated training.

1. Fire Prevention and Fire Fighting <5 years old

2. Personal Survival Techniques <5 years old
3. Advanced Fire Fighting <5 years old
4. Proficiency in Survival Craft and Rescue Boats <5 years old

OOW:

All:

1. UK Signals Certificate – issued within the last 3 years

2. NARAS/NAEST Operational
3. STCW - Advanced Fire Fighting
4. STCW - Certificate of Proficiency in Survival Craft and Rescue Boats (CPSC & RB)
5. STCW - Medical First Aid
6. Efficient Deck Hand (EDH)
7. HELM Operational
8. GMDSS GOC (Book)

Foundation Degree:

1. Course Completion Certificate/Letter

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All other routes:

1. SQA Safety Paper results

2. HNC Course Completion letter

Chief Mate Unlimited:

1. GMDSS GOC (Book)

2. UK NARAS/ NAEST (Management)
3. Medical Care Certificate (less than 5 years old)
4. HELM Management

Chief Mate Unlimited, less than 3000 GT unlimited area:

1. GMDSS GOC (Book)

2. NARAS Management
3. HELM Management
4. Medical Care Certificate (less than 5 years old)
Master Unlimited:

1. GMDSS GOC (Book)

2. Medical Care Certificate (less than 5 years old)
3. NARAS/NAEST (Management) and evidence of MCA approved NARAS/ NAEST (operational) or ECDIS training completed
after 01 January 2005.
4. HELM Management
Upgrade to Master less than 3000gt unlimited area, from Chief Mate Unlimited:

1. GMDSS GOC (Book)

2. Medical Care Certificate (less than 5 years old)
3. NARAS/ NAEST (Management) and evidence of MCA approved NARAS/ NAEST (operational) or ECDIS training
completed after 01 January 2005.
4. HELM Management

HELM: STCW Convention and Code, 1978 as amended 2010 brings in new requirements for leadership and management
training. Although the UK has identified that these requirements are broadly met in the current MNTB approved officer training
programmes for the operational level, specific training programmes in Human Element Leadership and Management (HELM)
have been developed at both the operational level (to be used for non-MNTB officer cadet training programmes) andat the
management level. For further information please refer to MSN 1856 Amendment 1 (section 10.4, page 12) which is available
on our website: Go to www.gov.uk and search MSN 1856 Amendment 1.

5 DECLARATION

Please read the declaration. Once you are sure that the information you have given is, to the best of your knowledge, true and
complete, and that the documents submitted are genuine, given and signed by the persons whose names appear on them,
you should digitally sign the declaration with your full name, including the date. Also please complete the Form Signature1
ensuring your signature is inside the box – this will be transferred to your CoC.

6 COUNTER DECLARATION

You should obtain a counter declaration from a responsible person who is NOT related to you and has known you for at least
2 years. They should enter their details in this section. This person is declaring that your application photograph is a true and
accurate likeness to the applicant. The MCA may contact this person by email to validate the counter declaration.

7 PAYMENT

You must enclose the correct fee with your application. The published fee includes worldwide postage. Please check (x) the
appropriate box to indicate your chosen method of payment. Payment must be made in pounds sterling (£).

IMPORTANT NOTE: If you are sending documents from outside the UK and indicate to your courier company that
the documents have a value of over £100 GBP, you will be liable to pay any import charges.

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 You must use this table if you are using yacht service. For definitions please refer to MSN 1858. For details of how yacht sea service is calculated towards a
Merchant Navy CoC please refer to Annex F of MSN 1856 Amendment 1 (page 30).

VESSEL AND VOYAGE DETAILS DATES(DD/MM/YYYY) DURATION SEA SERVICE DURATION (DAYS)

Actual
Length*/Type**/ Months Days Standby Yard Watch-
Vessel Name Flag GT Rank/Capacity From To Sea
Voyage*** Service
Service Service keeping

Totals

* Length - Load line length

** Type - Type of yacht (motor/sail)

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PRIVACY STATEMENT

Personal information which you supply to us will be used to process your application to meet the applicable Standards of Training Certification and Watchkeeping (STCW)
requirements. To check and report on how effective the MCA and the services it commissions have been. To make sure that the MCA gives value for money. We may use your
information to investigate complaints, legal claims or important incidents. We may use your information for crime prevention and prosecution of offenders.

The information you provide is primarily used for issuing your UK Certificate of Competency (CoC)/ Flag State Endorsement (Certificate of Equivalent Competency) (FSE) but may also
be used for other related purposes, and shared with other statutory bodies/organisations to enable them to fulfil their statutory obligations.

If you are required to sit a Part A: Online computer based proctored examination, some of the details provided on your application form (name and photograph) will be shared with our
third-party processor, to allow for an account to be set up for the Part A: Online computer based proctored examination to be undertaken. This information will be retained until such
time as the candidate passes the Part A exam. On passing the Part A exam, the user account will be permanently deleted after 90 days.

We will not disclose any financial details you provide to us. Once your payment has been processed all financial details are securely destroyed.

For more information on how we use your information, and your rights to access information we hold on you, please see our full privacy policy available on our website:

https://www.gov.uk/government/organisations/maritime-and-coastguard-agency

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*** Voyage - You should give the area in which the ship traded using the following codes U = Unlimited, NC = Near Coastal Area

New Sea Time Requirements for

Full Requirements in MSN 1856
Unlimited Route
Master, unlimited, II/2:
*18 months’ Oral Exam A
seagoing service (MSN 1856, refer to section 3.4,
page 6)

No

Have you 12 months’ *24 months’

sailed as Chief Mate Yes
seagoing service seagoing service
for 12 months?

Have you
Yes sailed as Chief Mate No
for 12 months
*This period may be reduced if you have
This must be a minimum completed more than 12 months as an OOW
of 12 months sailing as a prior to obtaining a Chief Mate’s CoC. You
Chief Mate – otherwise need to complete a total of 36 months from
you must complete the OOW. So for example:
full sea time requirement.
Chief Mate unlimited II/2: Chief Mate unlimited II/2: If you completed 22 months as an OOW Chief Mate unlimited II/2:
applicable applicable prior to qualifying as a Chief Mate, you must applicable
education and training education and training now complete a further 14 months as a Deck education and training
Oral Exam B Oral Exam B Officer to obtain a Master’s CoC: Oral Exam B
(MSN 1856 Section 3.3 page (MSN 1856 Section 3.3 page (MSN 1856 Section 3.3 page
5) 5) 22 + 14 = 36. 5)

You should submit all your sea service

since obtaining an OOW CoC.

18 months’ 12 months’ 36 months‘

seagoing service seagoing service seagoing service

OOW Unlimited, II/1:

applicable education and training, 12 months’ seagoing service or 36 months’ for non-approved route,
Came though old route (MGN 92)
Oral Exam C
(MSN 1856 refer to section 3.2, page 4)

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