Education ERP

ISO 9001:2015

International Maritime Training Academy (IMTA)
Corporate Office : S&F Bhaban (4th Floor) 153/1, Green Road, Dhaka- 1205, Bangladesh,
+8801325187961, 01711320119, 01979040813,
https://imtadhaka.com/

Registration No

C.D.C/P.P/NID: *

C.D.C No/P.P No/NID No: *

Full Name: *

Father's Name: *

Mother's Name: *

Contact No: *

Whats App No:*

Date Of Birth: *

Place Of Birth: *

Total Sea Time (If Applicable)

Competency Certificate Held(If Any)

Last Sailing Company

Emergency Contact Name: *

Emergency Contact Number: *

Last Rank Held

Last Educational Qualification

Present Address: *

Parmanent Address :

Password*

Confirm Password *

Document Attachment (All file size must be in 1.5 MB)

Photo (File must be jpg, jpeg, png) *

Browse

Scan copy CDC (File must be jpg, jpeg, png and pdf)

Browse

Signature(File must be jpg, jpeg, png)

Browse

I hereby, declare that the above information is correct to the best of my knowledge adn IMTA will not be responsible for any false or misleading information.