Participant Application Form — MARIA Structured Rollout Workshops

Thank you for your interest in the MARIA Structured Rollout Workshops. This form is used to register your interest, confirm your role, and reserve a seat in the relevant training session.

Important: Each workshop class slot is limited to a maximum of 10 participants. Seats are allocated on a first-come, first-served basis, so early submission is encouraged. Applicants not accommodated in their preferred session will be offered the next available date for their role.

1 Participant Details

Full Name *

Company / Organization

Job Title / Position

Department

Email Address *

Phone / Mobile Number

Years of Experience in the Maritime / Petroleum Industry

2 Role You Are Interested in Joining

Select ONE primary role that best matches your responsibility. If you are unsure, select the closest match and our team will confirm with you.

Malaysia Petroleum Management (MPM) Sept 28–30, 2026 — 2 hrs/session Petroleum Arrangement Contractor (PAC) Oct 5 & 7, 2026 — 3 hrs/session Vessel Inspection Company – Admin (VIC Admin) Oct 12–13, 2026 — 2 hrs/session Vessel Inspection Company – Inspector (VIC Inspector) Oct 14–16, 2026 — 4 hrs/session Vessel Technical Operator – Admin (VTO Admin) Oct 19–20, 2026 — 2 hrs/session Vessel Technical Operator – Superintendent (VTO Superintendent) Oct 21–23, 2026 — 4 hrs/session Other / Not listed Please specify below

3 Preferred Session Date

Please indicate your preferred date within your role's schedule (see Section 2). Preferred dates are not guaranteed and are subject to the 10-participant cap per slot.

1st Choice (Date)

2nd Choice (Date)

Time Availability

4 Pre-Workshop Questionnaire

1. Have you used the MARIA platform (or a similar vessel/marine assurance system) before?

Yes, regularly Yes, occasionally No, this will be my first time

2. How would you rate your comfort level with digital / web-based systems?

Very comfortable Somewhat comfortable Need guidance

3. What do you hope to learn or achieve from this workshop?

4. Do you have any specific questions or topics you would like the trainer to cover?

5. Will you require any accessibility accommodations or dietary requirements for an in-person session?

6. Preferred mode of attendance

In-person Online / Virtual No preference

5 Declaration

I confirm that the information provided above is accurate to the best of my knowledge. I understand that my registration is subject to available capacity (maximum 10 participants per session) and that I will be notified of my confirmed session date and time.

I agree to the declaration above

Signature (type your full name) *

Date

A confirmation email will be sent to the address you provide.