MSF 4259 REV 01/23

APPLICATION FOR AN ORAL EXAM LEADING TO THE

ISSUE OF AN STCW ELECTRO TECHNICAL OFFICER
(ETO) CERTIFICATE OF COMPETENCY (CoC)
ETO

IMPORTANT - BEFORE completing this form, please ensure you have read the guidance notes and
instructions on pages 7, 8 and 9.

Please post your application and supporting documents to UK Seafarer Services (Training &
Certification), Maritime and Coastguard Agency, Spring Place, 105 Commercial Road, Southampton SO15 1EG

1 PERSONAL DETAILS

Title Mr/Mrs/Miss/Capt etc Sex: Male/Female

Surname /Family name
Forename(s) in full
Date of Birth (DD/MM/YYYY)
Place of Birth Country of Birth
Nationality

Return Delivery Address

Address

District
Town/City
County/State
Post Code/Zip
Country
Email Address
Mobile No Tel No
Sponsoring Company Email, for UK Cadets only; Email:
we will copy your company in, if we request further
documentation and when we issue your NOE:

PLEASE TICK () ONE OF THE FOLLOWING ROUTES

Applicants following an MNTB approved training scheme leading to an ETO Certificate of Competency (3.2 of MSN 1860
Amendment 1)

Applicants not following an MNTB approved training scheme (3.3 of MSN 1860 Amendment 1)

Senior Electro-Technical Officer (5.1 of MSN 1860 Amendment 1)

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 ETO
2 SEA SERVICE

ALL RELEVANT SEA SERVICE MUST BE LISTED. If there is insufficient space, please continue on a separate sheet. Sea service on foreign flag ships will be accepted
under the same conditions as service on UK ships provided it can be properly verified.
LENGTH OF VOYAGE: this must be given in calendar months and days, e.g. from 3 January to 5 March = 2 months and 3 days. Odd days should be added together and
reckoned at 30 days to the month.
SHIP AND VOYAGE DETAILS DATES DURATION
Vessel Name IMO Number Flag Reg. Power (kW) Capacity FROM TO MONTHS DAYS

Total

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 ETO
3 - CHECKLISTS

Please note that failure to supply all the required documents may cause a delay in the processing of this
application. Please read the attached Guidance Notes before completing this section.

3A – For All Applications

These documents must be submitted prior to the issue of your NOE.  if Official
enclose use only
Attested copy of passport (please do not send original passport)

Discharge Book AND Sea Service Testimonials demonstrating the required sea service*
Payment – Please see section 6

STCW A-VI/1-1 Personal Survival Techniques < 5 years old or updated in last 5 years

STCW A-VI/1-2 Fire Prevention & Fire Fighting < 5 years old or updated in last 5 years

STCW A-VI/1-3 Elementary First Aid

STCW A-VI/1-4 Personal Safety & Social Responsibilities

Valid Medical Fitness Certificate** (ENG 1 or accepted equivalent)

One Passport-style Photograph (IMPORTANT See Guidance Notes)

MNTB ETO Training Record Book

* You must refer the guidance notes, section 3

**To comply with health and safety requirements in accordance with the Merchant Shipping Training & Certification (Medical
Examination) Regulations 2002 and STCW Regulation I/9, any seafarer employed or engaged in any capacity aboard a
seagoing vessel must hold a valid medical fitness certificate attesting to their medical fitness for the work for which they are
employed. Further information may be obtained from the MCA: go to www.gov.uk and search “seafarer medical” or click here.

3B – For Applicants Following an Approved Training Scheme Leading to an ETO CoC.

 if Official
These documents must be submitted prior to the issue of your CoC.
enclosed use only
Letter from the training institution stating that you are following an approved training program*

STCW A-VI/3 Advanced Fire Fighting

STCW A-VI/2 para 1-4 Proficiency in Survival Craft and Rescue Boats

STCW A-VI/4 para 1-3 Medical First Aid

AMERC GMDSS Radio Maintenance Course Completion Certificate

MCA approved Human Element Leadership and Management (HELM) (Operational Level)**

* You will need to provide this before we can issue you with an NOE.

** If you are completing an MNTB approved HND or Foundation Degree the HELM requirements will be covered in your
course. You are not required to submit a separate HELM certificate.
To satisfy Port State Control requirements:
We would recommend you carry the AMERC Electronic Navigation Equipment Maintenance (ENEM)
course completion certificate onboard the vessel you are serving on. You must carry your AMERC
GMDSS Radio Maintenance course completion certificate onboard the vessel you are serving on.

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 3C – For those who do not follow an MNTB or MCA-approved cadet training programme

If you do not follow an MNTB or MCA-approved cadet training course you may be eligible to apply for a UK ETO
CoC. You will need to apply to an MCA-approved nautical college who will assess your workshop skills training
and provide you with an action plan to meet the ETO standard. If you hold a relevant academic qualification you
will first need to apply directly to IAMI ([email protected]) who will complete an assessment of your
academic education and provide you with any exemptions you are entitled to.

You must refer to MSN 1860 Amendment 1 section 3.3 for further information

The UK nautical colleges who currently offer this route are South Tyneside College and Warsash Maritime
Academy:

https://www.gov.uk/uk-seafarer-careers-training-provision-and-information

Click on the link under: “Nautical colleges and training providers”.

You must submit the college action plan (and any IAMI exemptions) with your application.

3D For all applicants

Since the 01 January 2017 you are required to provide documentary evidence of either completing
the training course or updating your training within the 5 years preceding the issue of your
Certificate of Competency (for further information please refer to MSN 1865 Amendment 1):
Please Official
tick () use only

Fire Prevention and Fire Fighting < 5 years old

Personal Survival Techniques < 5 years old

Advanced Fire Fighting < 5 years old

Proficiency in Survival Craft and Rescue Boats < 5 years old

These certificates do not need to have been issued within the last 5 years to obtain your NOE, however
you must have have completed them within the last 5 years at the date you send in your NOE to obtain
your CoC or send in additional evidence of completing your updated training.

For further information please refer to MSN 1865 Amendment 1 – section 4.4 & 4.5, page 5 or MIN 535
Amendment 1.

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 ETO
4 DECLARATION (The maximum penalty for a false declaration is £5000)

I declare that the data contained in this application is, to the best of my knowledge, true and complete. I also declare that the
documents are genuine, given and signed by the persons whose names appear on them. I consent to any processing of the data
contained in this application by the MCA (including any processing necessary to establish the authenticity and validity of the
issued certificate). Please refer to our privacy statement in Section 2 of the guidance notes which explains how we use the
personal information we collect from you.
For office use only

Signature:

Today’s date: …………………………..

Please sign with your usual signature within the signature box above.

• Please print this form to sign it.

• You must use black ink only.
• You must not extend beyond the boundary of the box.
• The maximum dimensions for your signature are 0.6 cm (h) x 5.0 cm (w).
• You must scan in at a minimum of 200dpi and the signature must be clearly legible.

This signature will be transferred to your certificate. If your signature does not meet the above criteria,
we will not be able to issue your certificate.

Please ensure payment has been made and all required documents have been
provided. If your application is missing relevant documents or payment, your
application will be delayed and may not be assessed.

5 COUNTER SIGNATURE

Name

Address

Town /City

County/State
Post Code/Zip Country

Telephone No Occupation
Capacity in which you know the applicant
I declare that the information given is, to the best of my knowledge, true and complete. I also declare that the documents
submitted are, to the best of my knowledge, genuine and relate to the person(s) whose names appear on them. I confirm
that the photographs submitted bear a true current likeness of the applicant.

Signed……………………………………………………………………………….

Date………………………………………………………………………………….

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 6 PAYMENT

You must ensure you pay the appropriate fee (as laid down in the current Merchant Shipping Fees Regulations)

Payment should be made in pounds sterling (£), by BACs transfer, credit or debit card via online payment facility Gov.uk Pay
by following the links below.

We are unable to accept cheques, postal orders, banker’s drafts or cash.

The fee for an NoE application is £220.00 which includes the cost of a courier service.

 To pay via Gov.UK Pay for your Notice of Eligibility:

https://www.gov.uk/payments/seafarer-training-courses/application-for-electro-technical-officer

If you wish to pay by BACs transfer, please email [email protected] for our bank details.

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GUIDANCE NOTES FOR THE COMPLETION OF THIS APPLICATION FORM ETO

PLEASE ENSURE THAT YOU READ AND UNDERSTAND THESE NOTES BEFORE COMPLETING THE FORM

Please complete this form in BLOCK LETTERS and in black ink.

ENSURE YOU COMPLETE THIS FORM IN FULL - FAILURE TO DO SO MAY MEAN THAT WE WILL HAVE TO RETURN
YOUR APPLICATION TO YOU, AND WILL RESULT IN A DELAY TO YOUR APPLICATION BEING PROCESSED.

Enclose all documents necessary to establish your eligibility for examination for an STCW Certificate of Competency. Document
checklists are provided on pages 3, 4 & 5 to help you.

If eligible you will be issued with a Notice of Eligibility enabling you to sit an MCA oral examination. The Notice of Eligibility will
advise you how to apply for an appointment for the examination and what you should do once you have taken the examination.
The NoE will be valid for 5 years from the date of issue. Oral examination passes for each level of certification are valid for three
years. The oral examination pass must be in date at the time of issue of the CoC.

A series of Training and Certification Guidance Notes, giving further details of requirements are available from the Seafarer
Training & Certification Branch; the contact details are overleaf or they can be found on our website www.gov.uk.

1 PERSONAL DETAILS

Enter your personal details in the boxes provided. Your name should be given IN FULL, and should be given in the same format
as appears in your passport or other national identity document.

Your date of birth should be given in the format DD/MM/YYYY, e.g. 18 February 1960 would be written 18/02/1960.

You should give your permanent home address, where you are normally resident. You may also provide an alternative address
for return of documents or correspondence relating to this application, e.g. if you are away at College. Your documents will be
returned by courier and will need to be signed for. Please ensure you provide us with the full address and contact details of
where you would like your documents sent to should there be any queries with your delivery.

2 PRIVACY STATEMENT

Personal information which you supply to us will be used to process your application to meet the applicable Standards of
Training Certification and Watchkeeping (STCW) requirements. To check and report on how effective the MCA and the services
it commissions have been. To make sure that the MCA gives value for money. We may use your information to investigate
complaints, legal claims or important incidents. We may use your information for crime prevention and prosecution of offenders.
The information you provide is primarily used for issuing your UK Certificate of Competency (CoC)/ Flag State Endorsement
(Certificate of Equivalent Competency) (FSE) but may also be used for other related purposes, and shared with other statutory
bodies/organisations to enable them to fulfil their statutory obligations.

We will not disclose any financial details you provide to us. Once your payment has been processed all financial details are
securely destroyed.

For more information on how we use your information, and your rights to access information we hold on you, please see our full
privacy policy available on our website:

https://www.gov.uk/government/organisations/maritime-and-coastguard-agency

3 SEA SERVICE

Sea service must be supported by Discharge Book entries OR Certificates of Discharge AND sea service testimonials.
Testimonials must be signed by the Chief Engineer or Master or in exceptional circumstances by the Superintendent responsible
for the vessel.

If you are on an MNTB ETO approved cadetship you must demonstrate:

• not less than 12 months of combined workshop skills training and approved seagoing service of which:

 not less than 6 months shall be seagoing service as part of an approved training programme
including the on board training documented in MNTB ETO TRB;
 not less than 3 months shall be workshops skills training to MNTB ETO standard;

Workshop Skills should be demonstrated by a college certificate or college letter.

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 4 CHECKLISTS
Before a United Kingdom Certificate of Competency can be issued, you will need to submit certain documentation as specified in
this section. Any candidate failing to submit all the required documents may have their application returned without being
processed.

3A - ALL APPLICATIONS - ALL the documents in this section MUST be provided with this application before a Notice of
Eligibility will be issued. Please ensure you tick () each box to indicate that you have enclosed the documents.

Photograph: Your photograph must be taken full face without a hat and must be UK approved passport photograph,
measuring a maximum of 50mm x 40mm, in colour with a plain white background.

3B/C High Voltage Course:

Courses undertaken prior to 1 July 2013 do not need to be MCA approved, however you must provide documentary
evidence confirming the course covered:

• The hazards associated with High Voltage systems;

• The functional, operational and safety requirements for a marine high-voltage system;
• Arrangement of High Voltage systems and their protective devices;
• Safety procedures related to High Voltage systems;
• Remedial action necessary during faults in a high-voltage system;
• Assignment of suitably qualified personnel to carry out maintenance and repair of high-voltage switchgear of various types;
• Producing a switching strategy for isolating components of a high-voltage system;
• Selecting suitable apparatus for isolation and testing of high-voltage equipment;
• Carrying out a switching and isolation procedure on a marine high-voltage system, complete with safety documentation; and
• Performing tests of insulation resistance and polarization index on high-voltage equipment.

Acceptable courses are unlikely to have less than 24 hours contact time.

3B/C – Human Element, Leadership Management (HELM) Certificate:

The STCW Convention and Code, 1978 as amended 2010 brings in new requirements for leadership and management
training. Although the UK has identified that these requirements are broadly met in the current MNTB approved officer
training programmes for the operational level, specific training programmes in Human Element, Leadership and
Management (HELM) have been developed at both the operational level (to be used for non MNTB officer cadet training
programmes) and at the management level. If the HELM operational Training element was covered in your Training we
can accept a college letter confirming this in lieu of you taking the course.

For further information please refer to MSN 1865 Amendment 1 which is available on our website: go to www.gov.uk and
search: “MSN 1865 Amendment 1”

All Applicants:

To satisfy Port State Control requirements:

We would recommend you carry the AMERC Electronic Navigation Equipment Maintenance (ENEM)
course completion certificate onboard the vessel you are serving on.
You must carry your AMERC GMDSS Radio Maintenance course completion certificate onboard the
vessel you are serving on.

5 YOUR SIGNATURE AND DECLARATION

Please read the declaration. Once you are sure that the information you have given is, to the best of your knowledge, true and
complete, and that the documents submitted are genuine, given and signed by the persons whose names appear on them, you
should sign the declaration with your usual signature, including the date. Please ensure your signature is inside the box as this
will be transferred to your CoC.

6 COUNTER SIGNATURE
You should obtain a counter signature from a responsible person who is NOT related to you and has known you for at least
2 years. They should enter their details in this section. This person must endorse the rear of your passport style photograph
"I confirm that this is a true current likeness of [your name]", and add their usual signature and date. See also guidance
notes 4 on photograph.

7 PAYMENT
You must enclose the appropriate fee with your application. The fee includes worldwide postage. Payment must be made in
pounds sterling (£). Please sign to confirm the amount and chosen method of payment.