Applying for an
ADN Certificate

Your application is submitted via the CBR. Click one of the buttons below.

Note: the form opens in a new tab. After completing it, return to this page for the next steps.

Fill in the form and click “Continue”.

Review the information you entered and tick which documents you will attach. For Gas and/or Chemistry, you must also add a sea-time/service record or proof of refresher course attendance.

Then sign the form digitally (either by drawing your signature in the box or uploading an image of your signature).

Click “Continue”.

Need to request a service record? Use the button below.

Download the application form and send it to the CBR. You can do this in two ways:

By email:
Send an email to klantenservice.ccv@cbr.nl with the following attachments:

• The completed CBR application form

• A recent passport photo

• The service record (if applicable)

By post:
Print the form and send it together with a recent passport photo and, if applicable, the service record in a stamped envelope to:

CBR divisie CCV
P.O. Box 1810
2280 DV Rijswijk

Note: Don’t forget to include the attachments you selected in step 2 (passport photo and/or service record).

Click the blue download icon to download the form. The file will be saved in your computer’s “Downloads” folder.