Company Data

APPLICATION FOR

EMPLOYMENT

Date:

Position applied for: ABLE SEAMAN Available from: FROM NOW

Surname: AGADJANYAN Forenames: EDUARD

Date of Birth:03.12.1988 Place of Citizenship:GEORGIAN

Birth:BATUMI,GEORGIA

Address:7,LUKA ASATIANI STR.

City Country: BATUMI,GEORGIA

Phone (including code): Mobile phone:+995 558 96

64 44

E-mail:*******@*****.***

DOCUMENTS, PASSPORTS

Documents Grade Number Date Place Valid

Issued Issued Until

National Licence RAITING FORMING 033708 23.03.201 GEORGIA 29.03.201

PART FOR DECK 2 7

RATING

Endorsement of

National Licence

Tankerman

Endors.(oil,

chemical, gas)

DP Certificate

Travel Passport 09AK57291 04.05.200 GEORGIA 04.05.201

9 9

Seaman's Passport 014941 24.04.200 GEORGIA 24.04.201

7 7

Seaman's Book National LIBERIA NIL

Tourist Passport NIL

US visa NIL

PREVIOUS SEA EXPERIENCE (FOR LAST 5 YEARS):

From

Notes (it would be preferable if You could supply us with contact numbers

for references):

Company's name Phone number Person in charge

ALTITUDE SHIPMANAGEMENT +656******* Saad Tayyab

I hereby declare that the above is true. I further consent to the holding

and processing by you and any of your direct or indirect parent or

subsidiary or associated or affiliated companies (hereafter the "Company")

and your or Company's principals of personal data about me for all

purposes related to my application for employment on board vessels managed

by the Company or vessels owned or operated by third parties for whom the

Company is engaged to provide crew. I understand that this data will be

stored in your databases in relation to my actual or potential employment

by or through the Company. Further, I confirm that the above may involve

the transfer of my personal data within the Company or to third parties

worldwide.

Place: BATUMI,GEORGIA Date: 28.02.2013

Contact this candidate