Professional Documents
Culture Documents
Date 16-Mar-10
Phone
Mobile
Fax
Email captain_rosal@yahoo.com
B). NEXT OF KIN / DEPENDENTS - wife, children..or parents
Name Relationship DOB Address
Issued Expiry
Country/type Issue place (dd/mmm/yy) (dd/mmm/yy)
USA C1/D
Others
I). STCW95 MANDATORY COURSES / ENDORSEMENTS
Course / No. Remarks (Basic / Advanced /
Endorsement Issued Expiry Level 1 or 2 etc.)
(dd/mmm/yy) (dd/mmm/yy)
Advance Fire
Fighting
Medical Emergency
First Aid
Medical Care
PSC & RB
PSSR
Oil Tanker
Endorsement (DCE)
Chemical Tanker
Endorsement (DCE)
Gas Tanker
Endorsement (DCE)
Oil Tanker safety
Course
Chemical Tanker
Safety Course
Gas Tanker Safety
Course
GMDSS - National
Cert.
GMDSS - STCW
endorsement
Radar Observer
ARPA
RANSCO
& Automation)
Hydraulics &
Pneumatics
PMEW (Marine
Electrical)
K). SEA EXPERIENCE (starting from last vessel, in present rank and previous ranks)
Date On Date Off Sea Service
Ship
Employer Ship Flag Type Ship Name Rank DWT (dd/mmm/yy) (dd/mmm/yy) months/days
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
Please enter all dates in dd/mmm/yy format only.
Please fill in DWT for each vessel served compulsorily - enter approx. DWT if exact figure not known, to enable
automatic calculation of sea service..
L). EXPERIENCE ON TYPE OF M/E's and A/E's: (FOR ENGINEER OFFICERS ONLY):
MAIN ENGINES:
AUX. ENGINES:
M). REMARKS
1. DATE AVAILABLE TO JOIN VESSEL
2. YELLOW FEVER VACCINATION CERTIFICATE: issued expiry
3. Experience with Computerised Planned Maintenance Systems:
4. Membership in professional Organisations:
5. Any other Comments: