CAMPUS DRIVE APPLICATION FORM FOR 2019
 
Please read the below instructions before filling the online application forms (Click here for Step by Step Guide)
   
1. All candidates should read and understand the Eligibility Criteria before filling SIMS application form. Prospectus
2. Any candidate who does not meet the eligibility criteria but continues to fill the application form will not be allowed to proceed to the stage of interview. Also, such candidates will not be entitled to obtain any refund of his registration fees of Rs. 1100/-.

3. All information provided in this application form, is to be true and complete in all respect. If it is found that any misrepresentation or omission of information is done by the candidates it will be considered sufficient for withdrawal of the offer and dismissal from the course at any stage.

4. It will be assumed that Candidates have adhered to the following declaration:  

 
A. I shall not engage in or participate in any business or be self-employment during my training at SIMS. 
B. I shall not misuse controlled drugs or take part in any political or other illegal activities during my stay in SIMS premise. 
C. I have not submitted any false statement or submitted any document which I know to be false in order to obtain the admission at SIMS 
D. I confirm that my candidature is purely on my merit and does not involve any recommendations. 
E. I have not bribed any one in ESM, SIMS, Agent, or outside agencies to get my admission at SIMS. 
 
Course Selection

Please indicate the course you wish to apply for
before proceeding to fill up the form:

The batch you wish to apply is:
   
Personal Information
       
Aadhar Card Number    
First Name Middle Name
Last Name Date of Birth    
Highest Qualification Place of Birth
Marital Status Citizenship
Email Contact No. / Mobile No.
Height Weight
Mailing Address City
State Pin
Gender
Passport Size Photo
* Not exceeding 2MB
Father Name Father's Occuptation
Annual Income of the Family
(Includes income of earning members of the family)
Father's Contacts
       
Medical
       
Eye Sight Colour Blindness
Major illness/ operations undergone before    
If Yes, please provide details
   
(10th) Details
       
High School Name Pass in first attempt
Address City
State Pin
Board
Year of Education : From Year Of Passing
English % Aggregate %
       
(12th) / Diploma Details
       
College Name Pass in first attempt
Roll Number of Board Examination
(* Please enter "NA" if you don't have the roll number)
   
Address City
State Pin
Board
Year of Education : From Year Of Passing
Check here if you are still awaiting for the examination result :  
Please choose either one of the following to fill:  
       
Graduation Details (Optional, to be filled by candidates having BSc/ BE/ B Tech Degree)
       
College/Institute Name Pass in first attempt
Address City
State Pin
University Roll Number of University Examination
Stream No. of ATKTs
(Total no. of addl attempts made to pass in all subjects)
Year of Education : From Year Of Passing
Check here if you are still awaiting for the examination result :  
Please choose either one of the following to fill:  
       
Others
Preferred Choice of cities for online test:

Cities Available for Attending Online Test

   
 
How did you come to know about Samundra Institute of Maritime Studies, Lonavala?
(You may select more than one option.)
Newspaper/Magazine Facebook  
School/College Family/Relatives/Friends  
Edu Fair/ Job fair Emails sent by SIMS  
Directly contacted www.Shiksha.com  
Internet Talent Search Scheme Conducted
in School / Town / City
 
Others      
 
Examination Centres
   
Delhi ESM / SIMS Field Office Chandigarh ESM / SIMS Field Office
Executive Ship Management Pte Ltd
502A, Rectangle -I , D-4,
District Centre, Saket,
New Delhi –110017
Tel: + 91-11-49882700
Fax: + 91-11-2956-2777
Mob: +91- 9319611577
Email: admission.simsdelhi@samundra.com
Executive Ship Management Pte Ltd
CVU- 1, Central Plaza, Sector 105 Mohali Hills,
Banur Landran Road Greater Mohali
Tel: +91-160-6667777
Mob: +91-9888599076
Email: admission.simschandigarh@samundra.com
   
   
Chennai ESM / SIMS Field Office Cochin ESM / SIMS Field Office
Executive Ship Management Pte Ltd
Batra Centre 1st Floor
No. 28, Sardar Patel Road
Guindy, Chennai 600032
Tel: + 91-484-4151777- 8
Fax: + 91-484-2367275
Mob: +91-8412097523 / 9673799827
Email: admission.simschennai@samundra.com
ESM Complex, St. Ritas road
Near Gold Souke, (Adjacent to BRM Lights/ Ambika Pillai) Ponnurunny, Vytilla
Cochin - 682019
Tel: + 91-484-4151777- 8
Fax: + 91-484-2367275
Mob: +91-7356968485
Email: admission.simscochin@samundra.com
   
   
Mumbai ESM / SIMS Field Office Kolkata ESM / SIMS Field Office

Executive Ship Management Pte Ltd
Sai Commercial Annexe,BKS Devshi Marg
2nd Floor, Govandi Station Road
Govandi (East)
Mumbai ,Pin - 400088
Tel Nos : + 91-2114399517
Mob: + 91-91-8412097523 / 9673799827
Email: admission.sims@samundra.com

Executive Ship Management Pvt. Ltd.
Godrej Genesis, Unit No #503, 5th Floor
Plot#11, Block E.P & G.P, Salt lake
Sector V, Kolkata-700 091
Tel No: +91-612-3223692/612-3222622
Mobile No: +91-8051808332
Email : admission.simspatna@samundra.com
   
   
Patna ESM / SIMS Field Office  

Executive Ship Management Pte Ltd
1st Floor, J.M. Complex,
AS Colony,
Bailey Road, Rupaspur, Patna
Tel : +91-612-3223692/612-3222622
Mob: +91-8051808332
Email : admission.simspatna@samundra.com


   
Terms of Application
All related costs incurred as a result of the short listed applicant attending the interview, including cost of medical tests and psychometric test, shall be fully borne by the applicant himself.

 The list of successful candidates who are accepted for SIMS pre sea training, would be announced in our website. These candidates are to submit a non-refundable joining fee (except for caution fee which will be refunded after adjusting any dues) as per the schedule date stated in our website. Those who pay the joining fee within the time frame, will only be accepted for admission.

Any dispute concerning the interpretation of any of the terms and conditions of admission or prospectus shall be resolved amicably. If the student(s) / candidate(s) / parent(s) and the institute failed to resolve the dispute amicably, then the matter should be referred to the sole arbitrator to be nominated by the institute. The award passed by the sole arbitrator shall be binding on both the parties. The place of arbitration shall be the institute's premises only and the provisions of arbitration and conciliation act, 1996 shall apply to the arbitration proceedings.

Jurisdiction clause: - All legal disputes are subject to Mumbai / Pune court only.
 
Declaration by the Applicant

I declare that all information provided in this form, is true and complete in all respect. I fully understand that any misrepresentation or omission of information may be considered sufficient for withdrawal of the offer and dismissal from the course at any time. I also agree to the terms set out in Terms of Application.

I confirm that the information as set out in this application were provided by me and that the said information is true and correct.

I understand that I may be subject to prosecution if I have provided any information, which is false in any material particular or is misleading by reason of the omission of any material particular.

Further I, declare:

1. I shall not engage in or participate in any business or be self-employment during my training at SIMS.
2. I shall not misuse controlled drugs or take part in any political or other illegal activities during my stay in SIMS premise.
3. I have not submitted any false statement or submitted any document which I know to be false in order to obtain the admission at SIMS
4. I confirm that my candidature is purely on my merit and does not involve any recommendations.
5. I have not bribed any one in ESM, SIMS, Agent, or outside agencies to get my admission at SIMS.

I understand that if I breach any conditions above, during training at SIMS or even after training at SIMS, I will be subjected to:

1. Prosecution in court
2. Dismissal and pay all costs including Training fees if it is during training at SIMS prior employment onboard.
3. Immediate dismissal from the ship and I agree to pay SIMS:-
  a. all the cost incurred for my repatriation
  b. all the costs incurred for my relievers joining ship
  c. all the costs incurred, including training fee for my pre-sea training at SIMS
  d. all the costs incurred for my post-sea training at SIMS

 

 
 

Samundra Institute of Maritime Studies
The Training Commitment of Executive Ship Management Pte Ltd
78 Shenton Way, #21-00
Singapore 079120
Tel : +65 6324 0500
Fax : +65 6324 4544
esm@executiveship.com
www.executiveship.com