DAR ES SALAAM MARITIME TRAINING ACADEMY

DMTA F-1 ONLINE STUDENT REGISTRATION FORM

Basic Info

First Name *

Please Enter First Name

Middle Name

Please Enter Middle Name

Surname *

Please Enter Surname

Gender *

Please Enter Gender

Nationality *

Please Enter Nationality

National ID *

Please Enter National ID

Passport No

Please Enter Passport No

Place of Birth *

Please Enter Place of Birth

Date Of Birth *

Please Enter Date Of Birth

Contact Information

Phone *

Please Enter Phone

Email *

Please Enter Email

Address *

Please Enter Address

House No

Please Enter House No

Street

Please Enter Street

District *

Please Enter District

Region *

Please Enter Region

City Council (CC) | Municipal Council (MC) | District Council (DC) | Town Council (TC)

Next of Kin Information

Name *

Please Enter Name

Phone *

Please Enter Email

Address *

Please Enter Address

Academic Information

Program *

Please Enter Program

Batch

Please Enter Batch

Educational Info

Education Level *

Institution Information

Name *

Please Enter Name

Starting Year *

Please Enter Starting Year

Ending Year *

Please Enter Ending Year

Certificate * Maximum size: 800KB

Please Enter Certificate

Documents

National ID Copy * Maximum size: 800KB

Please Enter National ID Copy

Passport Copy Maximum size: 800KB

Please Enter Passport Copy

Birth Certificate * Maximum size: 800KB

Please Enter Birth Certificate

Photo * Maximum size: 800KB

Please Enter Photo