ATTACHMENT CESNI STANDARDS FOR MODELS IN THE FIELD OF PROFESSIONAL QUALIFICATIONS IN INLAND NAVIGATION

5. MODEL OF PRACTICAL EXAMINATION CERTIFICATE

We, name of the examining body, hereby certify with document number … that
1. Current family name(s) of the holder
2. Current first name(s) of the holder
3a. Date of birth (dd/mm/yyyy)
3b. Place of birth (city)
has passed the practical examination [for obtaining a certificate of qualification as a boatmaster] [and] [for a specific authorisation for sailing with the aid of radar]
on the simulator (name of the simulator), approved by (name of the competent authority).
Place and date of issue
Signature and stamp of the examining body

Instructions:
Names shall be entered as in the concerned person's ID card or in the concerned person's passport in UNICODE.
If a name is spelled differently in UNICODE and in ASCII, there shall also be a transcription in ASCII in brackets.
Choose the applicable examination and delete the other examination if not applicable.
Characteristics of the certificate: Colour: white background. Format A4 according to ISO 216.