APPLICATION FORM FOR DECK CADET
POST APPLIED FOR
DECK CADET
DATE OF AVAILABILITY
NAME ( AS IN PASSPORT)
SUDHIR GULIA
FATHER’S NAME
NARSINGH GULIA
PRESENT ADDRESS
H.NO-218,NEAR MIDFIELD SCHOOL,BADLI, DISTT-JHAJJAR,HARYANA,PIN CODE-124105
PERMANENT ADDRESS
H.NO-218,NEAR MID FIELD SCHOOL,BADLI DISTT-JHAJJAR,HARYANA,PIN CODE-124105
CONTACT NO.
E-MAIL ID
**************@*****.***
DATE OF BIRTH
23/10/1997
PLACE OF BIRTH
BADLI
NATIONALITY
INDIAN
MARITAL STATUS
SINGLE
FULL NAME OF NEXT OF KIN : NAR SINGH GULIA
RELATIONSHIP : FATHER
ADDRESS OF NEXT OF KIN :
H.NO-218,NEAR MID FIELD SCHOOL,BADLI DISTT-JHAJJAR,HARYANA,PIN CODE-124105
MOBILE NO: 941-***-****,981-***-****
ACADEMIC QUALIFICATIONS:
NAME OF DEGREE/DIPLOMA/QUALIFICATION
NAME OF
COLLEGE/INSTITUTE
YEAR OF PASS OUT
SECONDARY SCHOOL CERTIFICATE (S.S.C.)
DELHI PUBLIC SCHOOL BAHADURGARH
2012
HIGHER SECONDARY CERTIFICATE (H.S.C.)
DELHI PUBLIC SCHOOL BAHADURGARH
2014
PRE-SEA TRAINING INSTITUTE
INTERNATIONAL MARITIME INSTITUTE, GREATER NOIDA
2016
DOCUMENTS DETAILS:
DOCUMENTS
NUMBER
DATE OF ISSUE
DATE OF EXPIRY
PLACE
PASSPORT
Z3274874
19/08/2015
18/08/2025
DELHI
INDIAN CDC
MUM 261945
08/07/2016
07/07/2026
MUMBAI
INDOS NO.
15NL1653
30/09/2015
-
MUMBAI
DC ENDORSEMENT (OIL)
CMMI/OIL/16/18533
09/09/2016
04/09/2020
MUMBAI
NAME OF COURSE
CERTIFICATE NO
DATE OF ISSUE
PLACE OF ISSUE
NAME OF TRAINING INSTITUTE
PERSONAL SURVIVAL TECHNIQUE (PST)
PST-4784
16/09/2015
GREATER NOIDA
INTERNATIONAL MARITIME INSTITUTE
ELEMENTARY FIRST AID (EFA)
EFA-4784
16/02/2016
GREATER NOIDA
INTERNATIONAL MARITIME INSTITUTE
PERSONAL SAFETY & SOCIAL RESPONSIBILITY (PSSR)
PSSR-4822
09/01/2016
GREATER NOIDA
INTERNATIONAL MARITIME INSTITUTE
FIRE PREVENTION & FIREFIGHTING ( FPFF)
FPFF-5797
02/09/2015
GREATER NOIDA
INTERNATIONAL MARITIME INSTITUTE
SECURITY TRAINING FOR SEAFARERY WITH DEYIGNATED SECURITY DUTIES
ST-1168
19/02/2016
GREATER NOIDA
INTERNATIONAL MARTIME INSTITUTE
OIL TANKER FAMILIARIZATION (OTFC)
BTOT-099
27/06/2016
GREATER NOIDA
INTERNATIONAL MARITIME INSTITUTE
AUGMENTATION COURSE
08/09/2016
MUMBAI
TRAINING SHIP RAHMAN
MEDICAL FIRST AID
702/065/017
20/07/2017
SEC-28 DWARKA
SRI RAM INSTITUTE OF MARINE STUDIES
ADVANCE FIRE FIGHTING
1243/103/017
28/07/2017
SEC-28 DWARKA
SRI RAM INSTITUTE OF MARINE STUDIES
PSCRB
1545/098/017
04/08/2017
SEC-28 DWARKA
SRI RAM INSTITUTE OF MARINE STUDIES
SEA EXPERIENCE:
NAME OF COMPANY
NAME OF VESSEL
VESSEL TYPE
GRT
BHP
RANK
FROM
TO
DARYA SHIP MANAGEMENT
DAWN KANCHIPURAM
PRODUCT TANKER
29141
10150
DECK CADET
02/10/2016
17/06/2017
I HERE BY CONFIRM THAT THE INFORMATION CONTAINED WITHIN THIS DOCUMENT IS CORRECT TO THE BEST OF MY KNOWLEDGE.
DATE: 03 OCT 2017 SUDHIR GULIA