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.

991*******

E-MAIL ID

ac2ns7@r.postjobfree.com

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

056**********

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

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