Application for a Marine Pilot Licence – New Licensees

This form is to apply for a pilot licence in Victoria. If you already hold a Victorian pilot licence for another port you must still complete this Application form. Licences are ongoing unless cancelled.

"*" indicates required fields

Applicant Details

This form is applicable under the Marine Safety Act 2010 (Vic), Marine Safety Regulations 2012 (Vic), Training and Licensing of Marine Pilots for Victorian Ports Standard (Vic)
Name*
Date of birth*
Gender*

Residential address*
Postal address*

Your employer details

Ports and areas of operation

For which port(s) and areas of operation is the pilot licence required?*

Training

Provide details of all relevant training you have undertaken
Name of course
Training provider
Date completed
 

Tug boat observer experience

Have you been a master on a tug in the past 5 years? If yes - please mark the "yes" button below and go straight to the declaration and signing section. If no - please mark the "no" button below and provide the details of your tug boat observer experience (minimum of 10 hours is required) in the table below.
Have you been a master on a tug in the past 5 years?
Tug boat observer experience (minimum of 10 hours is required)
Name of tug
Port of registry
Operations - port area/berth
Date from
Date to
Number of hours
 

Attachments

As part of the application you must attach the following supporting documentation:
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
Photo must be less than 12 months old, showing a full front view of your head and shoulders without any head covering or tinted glasses. If you wear a head covering for religious reasons, a photograph showing your facial features is acceptable. If you normally wear prescription glasses, you must be wearing glasses with untinted lenses. The photograph must have a plain and lightly coloured background.

Declaration and signature

Declaration
DD slash MM slash YYYY

What happens next?

Once we have reviewed your form we will get in touch using the contact details required.