Republic of the Philippines

Department of Transportation and Communications

NATIONAL TELECOMMUNICATIONS COMMISSION

Regional Office No. VII

FORM B

1 X 1
ID Picture

APPLICATION FOR RADIO OPERATORS EXAMINATION

Check type of examination being applied for :
( ) RROC-Ship El. 1 2
( ) OTHERS __________ El. 1 2 3 4 CODE

(
(

) REC El. 1 2 3 4
) GOC EL. 1 2 3 PE CODE

Place of Exam : _________________________________________________

APPLICANT :

Date of Exam : _______________

______________________________________________________________________________
(last name)
(first name)
(middle name)

MAILING ADDRESS : _______________________________________________ Tel. No. : ____________________________

Date of Birth : __________ AGE : _____Place of Birth : ________________________________Citizenship ______________
SCHOOL ATTENDED : ___________________________________________________________________________________
COURSE TAKEN : ___________________________________________YEAR GRADUATED _________________________
TRAINING CENTER ATTENDED (for GOC) _________________________________________________________________
WILLFUL FALSE STATEMENTS AND SUBMISSION OF FAKE
DOCUMENTS MADE IN THIS APPLICATION WILL AUTOMATICALLY
DISQUALIFY APPLICANT TO TAKE THE EXAMINATION

Cashiers Stamp :

______________________________
SIGNATURE OF APPLICANT

Requirements to be submitted :

RROC-SHIP
Certificate of completion of RROC seminar
Copy of PRC certificate/ID
2 (two) pcs. 1 X 1 ID picture
2 (two) mailing envelopes (w/stamp)

RADIO ELECTRONIC
CERTIFICATE
Certificate of completion of REC seminar
Copy of valid 1RTG & GOC certificates
2 (two) pcs. 1 X 1 ID picture
2 (two) mailing envelope w/ stamp
Copy of sea service employment for at least one
(1) year on board commercial or training vessel as
Electrician, electronic engineer or radio electronic
trainee (for BSECE or ECE)

Records Verification

FOR REMOVAL :
Copy of result of rating of the last
examination
2 (two) pcs. 1 X 1 ID picture
1 pc. Mailing envelope w/ stamp

GENERAL OPERATOR
CERTIFICATE
Certificate of completion of seminar
SRROC, INMARSAT, GMDSS
Copy of PRC certificate/ID
2 (two) pcs. 1 X 1 ID picture
2 (two) mailing envelope w/ stamp
copy of refresher course certificate (for those w/o
one year of service on board sea going vessel w/
GMDSS equipment)

Name and Signature

________________________________________________________________________________________________________
________
TO : THE CHAIRMAN, Radio Operators Examination Committee
PLEASE ADMIT Mr./Ms. ________________________________________________________________________________
With mailing address at ___________________________________________________________________________________
In the class/type and date of examination indicated below :
( ) RROC-Ship El. 1 2
( ) R E C El. 1 2 3 4
( ) OTHERS __________El. 1 2 3 4 CODE
( ) G O C EL. 1 2 3 PE CODE
NOTES :
1. examination starts at 8:00 AM or as designated two days before the date of examination
2. Examinees late for more than 30 minutes will be considered absent.
3. Request for re-schedule of examination must be filed at least 1 week before the date of examination
Date of Exam : ____________________

DANILO T. SY, CESO V

Regional Director

Address :
Tel. No .:
E-mail
:
Web Site :

Logarta Cor. Lopez Jaena St., Subangdaku, Mandaue City

(32) 345-0823, Telefax : (32) 422-6822
ntcr7@cvis.net.ph
http://r7.ntc.gov.ph

1 x 1
ID picture

Place of Exam: __________________________