Online Application Registration Form

Basic Training For Oil and Chemical Tanker Cargo Operations (OCTCO)
Fields marked with * are mandatory
Personal Details
  Request For Date*
  Application No.
  Name of the Candidate*
  Father's Name*
  Date of Birth*
  Marital Status*
  Indos No:*
  Basic Safety Training Course(STCW) Completed:* YesNo
  CDC No.:
  Valid Till:
  Passport No.:
  Valid Till:
Address for Communication
  Flat/Door/Name of Building*
  Area / Locality*
  State/Union Territory*
  Phone - Home
(Please give a valid Number)
(Please give a valid Email ID)
  Applying through*

How did you come to know about RLINS?
All correspondence / updates will be sent to this EMail ID / Mobile No.
  How did you come to know about RLINS?
Through Institute Website
Through RLINS Letter
Through NewsPaper Advertisement
Through Friends/Relatives
Through Students Of RLINS
Accommodation Required YesNo

Bank Details

Name of beneficiary- R.L. Institute of Nautical Sciences
Beneficiary's Bank Name- City Union Bank
Address- 82A, Tamil Sangam Road, Madurai - 625 001
Account No. - 027109000119084
Account Type. - Current A/c
Branch Madurai Main
IFSC Code CIUB0000027
  Mode of Payment*

  UTR No *
  Date of remittance (dd/mm/yyyy)*
  Name of the Remitting Bank*
  Branch Name & Place*