Evidence of Identity

Evidence of Identity for

(if you’re booking in multiple people, make sure you log out and log back in as each new user)

Click here to read the Evidence of Identity Requirements.

Course details

Course location

Course date

Course start time

Course ID

Course type

First Name *

Last name *

Mobile number *

Email *

If you're trying to fill this form out for someone else you'll need to sign out and sign back with their account.

Date of birth

(dd/mm/yyyy)

Gender

Male

Female

Current address (as it appears on your ID) *

Current address (as it appears on your ID)

Address line 1

Address line 2

City

State

Post code

Do you have a driver's licence? *

Yes

Driver's licence details

Photo Drivers Licence/Photo Learner Permit Number:

Licence Front Upload *

Maximum file size: 20MB

Licence Back Upload *

Maximum file size: 20MB

Other identity details

If you do not hold a drivers licence you will be required to provide two forms of ID from the list allowed by Maritime Safety Victoria. Click here to see the Evidence of Identity Requirements.

For you to be eligible for a certificate, Adam’s Boat Course staff must sight the original identification documents detailed on this form.
If you cannot demonstrate your residency through your identification you will need to complete a Referee Statement for Evidence of Address form.

Please contact us if you are unsure about the Evidence of Identity Requirements

Proof of identity primary ID type *

Proof of identity primary ID number *

Proof of identity secondary ID type *

Proof of identity secondary ID number *

Proof of Identity document upload *

Maximum file size: 10MB

Document upload 2

Maximum file size: 10MB

If required

Document upload 3

Maximum file size: 10MB

If required

Document upload 4

Maximum file size: 10MB

If required

Eligibility check *

I have been informed by Mick's Boat Course of the eligibility criteria to obtain a Marine Licence, as required by section 53 or 54 of the Marine Safety Act 2010 (Vic), and regulation 30 of the Marine Safety Regulations 2012 (Vic)

Student's Signature *

Clear

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Contact us

If you have any questions get in touch.



0414 952 444



Evidence of Identity

Evidence of Identity for

Course details

Driver's licence details

Other identity details

Contact us

0414 952 444

info@mjetc.com.au