*. PERSONAL DETAILS
Surname : RAI
First Name : AMIT
Middle Name : KUMAR
Nationality : INDIAN
Date of Birth : 11/02/1995
Place of Birth :BAGAR,BIHAR
Weight (kg) : 71
Height (cm) : 175
Post Applied for : DECK CADET
Permanent Address : VILL-PO-BAGAR, PS-SIKRAHATA, DIST-BHOJPUR,BIHAR
Present Address : VILL-PO-BAGAR, PS-SIKRAHATA, DIST-BHOJPUR,BIHAR
PIN Code:802222
Nearest Airport: PATNA
PIN Code:802222
Tel No / Mobile No:088********
Tel No / Mobile No:088********
Email ID:***************@*****.***
2. PASSPORT DETAILS
Passport No.
Date of Issue
Place of Issue
Date of Exp.
ECNR
Blank Pages
P0559114
24/06/2016
PATNA
23/06/2026
36
3. CONTINUOUS DISCHARGE CERTIFICATE / INDOS
Seaman’s Book (CDC)
Number
Date of Issue
Place of Issue
Expiry Date
Remark
Indian
MUM274955
12/05/2017
MUMBAI
11/05/2027
-
INDOS
14NL1182
27/08/2014
MUMBAI
-
-
4. FAMILY INFORMATION
Full Name of Next of Kin : ARVIND KUMAR RAI
Relationship : FATHER
Address of Next of Kin: VILL-PO-BAGAR, PS-SIKRAHATA, DIST-BHOJPUR,BIHAR
Tel No. : 088********
Family Data
Name
Contact Number/e-mail ID
Father
Arvind kumar rai
Mother
Kiran devi
Brother
Bipul kumar
5. ACADEMIC QUALIFICATION
QUALIFICATION
YEAR OF PASSING
PERCENTAGE
BOARD/UNIVERSITY
B.Sc. Nautical Science
2017
70.18%
Y.C.M.O.U
H.S.C.
2014
68.40%
B.S.E.B
S.S.C.
2011
89.30%
C.B.S.E
6. DETAILS OF B.TECH (MARINE) COURSE:
SEMESTER
PERCENTAGE
AVERAGE %
SEMESTER 1
71.50%
70.18%
SEMESTER 2
65.83%
SEMESTER 3
71.83%
SEMESTER 4
66.33%
SEMESTER 5
69.80%
SEMESTER 6
75.80%
7. STCW AND OTHER COURSES
Details of Courses & Certificates
Number
Dt. Of Issue
Dt. Of Expiry
Pl. of Issue
Issued by
Elementary / Medical First Aid / Medicare
MANET/EFA/20/2015/016
01/07/2015
30/06/2020
PUNE
MAEER's Maharashtra Academy of Naval Education and Traning
Personal Safety & Social Responsibility (PSSR)
MANET/PSSR/20/2015/016
04/07/2015
03/07/2020
PUNE
MAEER's Maharashtra Academy of Naval Education and Traning
Advanced / Basic Fire Fighting
FPFF/042/16
04/06/2016
04/06/2021
KOLKATA
MERCANTILE MARINE ACADEMY
Proficiency in Survival Craft / Rescue Boat / PST / PSC RB Up gradation
PST/022/16
08/06/2016
08/06/2021
KOLKATA
MERCANTILE MARINE ACADEMY
Security Training for Seafarers with Designated Security Duties (STSDSD)
STS/063/16
10/06/2016
10/06/2021
KOLKATA
MERCANTILE MARINE ACADEMY
8. OTHER CERTIFICATES
1
Soft Skills Training Program
2
Body language, Time Management and Leadership Training Program
8. DECLARATION
I hereby affirm that all the information provided by me in this application is true and correct to the best of my knowledge and belief; further, that no Certificate issued to me has ever been Revoked or Suspended.
Date: 05/10/2017 Name: AMIT KUMAR RAI Signature: