<p> Republic of the Philippines Department of Information and Communications Technology NATIONAL TELECOMMUNICATIONS COMMISSION Regional Office No. VII</p><p>APPLICATION FOR RADIO OPERATOR’S EXAMINATION 1 X 1 Check type of examination being applied for : ID Picture ( ) RROC-Ship Low Power El. 1 2 ( ) PHN : El. 1 2 3 4 ( ) RMAP ( ) RTG : EL. 1 2 3 CODE ( ) Others : ______</p><p>Place of Exam : ______Date of Exam : ______APPLICANT : ______(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) ______</p><p>“ WILLFUL FALSE STATEMENTS AND SUBMISSION OF FAKE Cashier’s Stamp : DOCUMENTS MADE IN THIS APPLICATION WILL AUTOMATICALLY DISQUALIFY APPLICANT TO TAKE THE EXAMINATION”</p><p>______SIGNATURE OF APPLICANT Requirements to be submitted : Records Verification RROC-SHIP LOW POWER FOR REMOVAL : Copy of result of rating of the last examination Copy of PRC certificate/ID 2 (two) pcs. 1 X 1 ID picture 2 (two) pcs. 1 X 1 ID picture 1 pc. Mailing envelope w/ stamp 2 (two) mailing envelopes (w/stamp)</p><p>PHN / RTG RMAP-AIRCRAFT Pilot License or student pilot license Copy of Transcript of Records with S.O. 3 (three) pcs. ID picture & mailing envelop 3 (three pcs. 1 X 1 ID picture 2 (two) mailing envelope w/ stamp UPGRADING PHN / RTG Copy of Birth Certificate Photo copy of ROC Name and Signature 3 (three pcs. ID pictures & mailing envelop</p><p>------</p><p>TO : THE CHAIRMAN, Radio Operators Examination Committee</p><p>PLEASE ADMIT Mr./Ms. ______1 x 1 With mailing address at ______ID picture In the class/type and date of examination indicated below : ( ) RROC-Ship Low Power : El. 1 2 ( ) PHN : El. 1 2 3 4 ( ) RMAP ( ) RTG : EL. 1 2 3 CODE ( ) OTHERS ______El. 1 2 3 4 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</p><p>Date of Exam : ______Place of Exam: ______</p><p>JESUS M. LAURENO, PECE Regional Director</p>
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