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AC.

64
Jan. 27, 2016
Rev. 0

NAMEI Polytechnic Institute


123 A. Mabini Street, Mandaluyong City

QUALITY FORM
(MARITIME EDUCATION DEPARTMENT)

EXAMINATION FORM
STCW REFERENCE :
STCW FUNCTION :

STCW COMPETENCE :
SUBJECT CODE :
SUBJECT DESCRIPTION :
1.
Target Learning Outcomes : 2.
(Knowledge, Understanding & Proficiency) 3.
4.
Course/Year: Preliminary Examination Final Examination
Midterm Examination
Test Questionnaires:
Part I Instruction: Number of Number of point/s
items: per item:

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Part II Instruction: Number of Number of point/s


items: per item:

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Part III Instruction: Number of Number of point/s


items: per item:

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Part IV Instruction: Number of Number of point/s


items: per item:

Note:
 Do not write anything on the examination form. Vandalism on examination form will be punishable of
termination of the exam and it will not be recorded.
 Instructions, number of items, points per item and other details will be filled by the instructor on the said
subject.

Prepared by: Reviewed/Validated by: Approved by:

CAPT. JULIUS F. DELA CRUZ CAPT. DANIEL P. FAJELAGUTAN

Instructor Department Head/Assessor Dean

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