MD 698
MD 698
MD 698
MARINE DEPARTMENT
THE GOVERNMENT OF THE HONG KONG SPECIAL ADMINISTRATIVE REGION
培訓合格證書申請表(遠洋)
Application for a Certificate of Proficiency (Seagoing)
註:填寫本表格前,請參閱第 3 至 4 頁的「填表須知」及「收集個人資料聲明」。
Note: Please read the ‘Guidance Notes’ & ‘Personal Data Collection Statement’ on page 3 to 4 before filling in this form.
Chinese Name 中文姓名(if applicable 如適用) Sex 性別 Date of Birth 出生日期 Nationality 國籍
(DD 日/MM 月/YYYY 年)
Telephone No. 電話號碼 Passport No. / H.K. Identity Card No. 護照或香港身分證號碼
(Home 住宅) (Mobile 手提)
Full postal address (for acknowledgement and return of your documents) 回郵地址(通知及寄回文件之用)
(Home 住宅)
3 Declaration 聲明書
I declare that 本人謹此聲明:-
(i) I have read the‘Guidance Notes’ & ‘Personal Data Collection Statement’ appended to this application form carefully;
and
我已細閱此申請書附載的「填表須知」和「收集個人資料聲明」;以及
(ii) the information and documents submitted herein and with this application form are full, true and complete to the best of
my knowledge and belief.
就我所知所信,所有填報於此申請書的資料及一併提交的文檔均屬全面、真實及完整。
It is an offence under the Merchant Shipping (Seafarers) (Safety, Security and Designated Duties Training) Regulation, the
Merchant Shipping (Seafarers) (Tankers) Regulation, the Merchant Shipping (Seafarers) (Ships Operating in Polar Waters)
Regulation and the Merchant Shipping (Seafarers) (Ships Using Low-flashpoint Fuels) Regulation to give false information.
根據《商船(海員)(安全、保安及指定職責培訓)規例》、《商船(海員)(油船)規例》、《商船(海員)(極
地水域操作船舶)規例》和《商船(海員)(使用低閃點燃料船舶)規例》,提交不正確資料,實屬違法。
General 一般事項
Fee 收費
4. Certificate of Proficiency is issued free of charge. 4. 簽發培訓合格證書費用全免。
1. Purposes of Collection
1. 收集目的
The personal data provided by means of this form will be used
海事處會使用透過本申請表所獲得的個人資料
by Marine Department for the following purposes:
作下列用途:
(a) activities relating to the processing of your application in
(a) 辦理有關審批你在本申請表中所提出的申
this form;
請的事務;
(b) facilitating communication between Marine Department and
yourself; (b) 方便海事處與你聯絡;
(c) assisting in the enforcement of any other Ordinances and (c) 藉此協助其他政府決策局和部門執行其他
Regulations by other Government Bureaux and 法例和規例;
Departments; (d) 成功申請人的有限個人資料會用於海事處
(d) limited personal data of successful applicants may be used 的互聯網網頁以供第三者查證本處所發出
via the Marine Department’s Internet web site for 的證書;
verification of the issued certificate by any third party; (e) 供作統計及研究用途,但所得的統計數字或
(e) for statistics and research purposes on the condition that the 研究成果,不會以能辨識各有關的資料當事
resulting statistics or results will not be made available in a 人或其中任何人的身份的形式提供;以及
form which will identify the data subjects; and
4. Enquires 4. 查詢
Enquiries concerning the personal data collected by means of 有關透過本申請表收集的個人資料的查詢,包
this form, including the making of access and correction, 括索閱及修正資料,應寄往:
should be addressed to:
Officer-in-charge 香港
Seagoing Examination and Mercantile Marine Office 中環統一碼道 38 號
Marine Department 海港政府大樓 3 樓 302 室
Room 302, 3/F, Harbour Building 遠洋航行考試及商船海員管理處主管
38 Pier Road, Central 電郵: sssem@mardep.gov.hk
Hong Kong
Email: sssem@mardep.gov.hk