Formulir Calon Pasis
| Nama | Tempat Lahir | Tanggal Lahir | No HP | Diklat Peningkatan | Jurusan | KTP | Ijazah Umum | Akta Kelahiran | SKCK | Upload SKCK | STTPK | Buku Pelaut | Masa Layar | Upload Masa Layar | COC ANT/ATT III | COC ANT/ATT IV | Foto | Sertifikat Deck | Sertifikat Engine | BST | PSCRB | AFF | MFA | MC | RS | AS | SSO | ECDIS | BRM | ERM | |
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| Syarman | Balikpapan | 04/09/1988 | +6285387824497 | syarmansyarman37@gmail.com | DP-III | Teknika | Lihat | Lihat | Lihat | Lihat | Lihat | Lihat | Tidak ada | Lihat | Lihat | Basic Safety Training, Proficiency in Survival Craft and Rescue Boats, Advanced Fire Fighting, Medical First Aid | http://caks-banten.org/wp-content/uploads/fluentform/ff-16bfa106f59c54fe14852236334be943-ff-BST.pdf | http://caks-banten.org/wp-content/uploads/fluentform/ff-8ac1efc3ddd012c2fdfbf9abf498f586-ff-PSCRB.pdf | http://caks-banten.org/wp-content/uploads/fluentform/ff-6424479f868f1f3bacea1bbce506a383-ff-AFF.pdf | http://caks-banten.org/wp-content/uploads/fluentform/ff-6d0c8e011177f96d3231d065727382bd-ff-MFA.pdf |
Pembayaran Diklat Peningkatan
| Nama Lengkap | Bukti Transfer | Jumlah Transfer | Tanggal Transfer | Nama Rekening Pengirim | Nama Bank | Keterangan |
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