Application for Sea-Going Employment
POSITION APPLIED FOR: OILER (ABLE SEAFARER ENGINE) / MOTORMAN
(This form is to be filled by the applicant in BLOCK LETTERS. Attested photocopies of all certificates of competency and proficiency and all other documents used to support this application must be attached)
THIS FORM HAS BEEN DESIGNED TO PROVIDE US WITH THE BASIC INFORMATION REQUIRED FOR FACILITATING THE PROCESSING OF YOUR APPLICATION FOR YOUR EMPLOYMENT WITH US. IT ALSO SERVES AS PERSONAL RECORD SHOULD YOU BE EMPLOYED. IT WOULD THEREFORE BE VERY ESSENTIAL FOR YOU AND HELPFUL FOR THE APPRAISAL THAT THE FORM IS COMPLETED NEATLY AND FACTUALLY. ALL PARTS ARE TO BE COMPLETED. DELETE ITEMS WHICH ARE NOT APPLICABLE TO YOU.
PERSONAL PARTICULARS
Name as per NRIC/Passport
BUGHARI BIN MOHAMAD RAMLI
NRIC (for Malaysian only)
880311 08 - 5733
Nationality
MALAYSIAN
Date of Birth
11 MARCH 1988
Place of Birth
KAMUNTING, TAIPING
Marital Status
SINGLE
Religion
ISLAM
Home Address
NO. 11, KAMPUNG SG. LARUT, BATU 3, JALAN
SIMPANG, 34000 TAIPING, PERAK DARUL RIDZUAN.
Contact Number
Main:+601*-*******
Alternative:-
Size
Shoes :41
Coverall : L
Email Address
*******.*****@*****.***
Nearest Airport
IPOH AIRPORT
Account Details
MAYBANK (157*********)
Availability
END OF DECEMBER 2017
NEXT OF KIN S PARTICULAR
Name as per NRIC/Passport
RABAIE BIN HAJI MOHAMAD RAMLI
Relationship
LITTLE BROTHER
Date of Birth
15 FEBRUARY 1989
Home Address
NO. 11, KAMPUNG SG. LARUT, BATU 3, JALAN
SIMPANG, 34000 TAIPING, PERAK DARUL RIDZUAN.
Contact Number
Main:+6012 - 4329243
Alternative
Email Address
-
IDENTIFICATION AND TRAVEL DOCUMENT DETAILS
Passport No
A35387973
Date of Issue
11 JUNE 2015
Date of Expire
3 DECEMBER 2020
Issuing Country
TAIPING, PERAK
SEA GOING DOCUMENTS
Seaman Card No
Seaman s Book No
4583400015A
Date of Issue
28/08/2009
Date of Issue
28/08/2009
Date of Expire
05/09/2014
Date of Expire
04/09/2019
Issuing Authority
JAB. LAUT LUMUT
Issuing Authority
JAB. LAUT LUMUT
C.O.C/Watch keeping Cert
CERTIFICATE OF WATCHKEEPING RATING FOR ENGINE
Date of Issue
30/07/2012
Date of Expire
-
Issuing Authority
JABATAN LAUT LUMUT
Place Medical Examination
BERKAT AMPANG CLINIC
Date of Issue
18/10/2016
Date of Expire
17/10/2018
Vaccination
Yellow Fewer:
Cholera:
Others:
EDUCATION BACKGROUND
College /School Attended
Period
Qualification Obtained
POLITEKNIK UNGKU OMAR, IPOH
3 YEARS
DIPLOMA IN MARINE ENGINEERING
TRAINING AND OTHER CERTIFICATES
Certificates
Date of Issue
Place/Collage of Issue
BOSET / Huet with EBS
28/07/2017
SEQU OFFSHORE SDN BHD
Basic Safety Training (BST)
07/10/2015
PENJANA ILMU SDN BHD
Personal Survival Techniques
07/10/2015
PENJANA ILMU SDN BHD
Basic Fire Fighting
07/10/2015
PENJANA ILMU SDN BHD
Elementary First Aid
07/10/2015
PENJANA ILMU SDN BHD
Personal Safety and Social Responsibility
07/10/2015
PENJANA ILMU SDN BHD
Proficiency in Survival Craft and Rescue Boat
23/12/2011
PELITA AKADEMI, KKB
Fast Rescue Boat
Advance Fire Fighting
10/04/2017
PELITA AKADEMI, KKB
Medical First Aid
23/12/2011
PELITA AKADEMI, KKB
Medical Care
ARPA operation Cert
Radar Simulator
Radar Observer
General Operator Certificate (GMDSS Operator)
Electronic Navigation Aid
Rigging & Slinging
Tanker Familiarization
Ship Security Officer Certificate
Shipboard Management Certificate
Bridge Team Management
Dynamic Positioning Induction Course
Dynamic Positioning Simulator Course
Dynamic Positioning Operators Certificate
Other Certification (DESIGNATED SECURITY DUTIES)
14 & 15/04/2014
POLARIS MARITIME ACADEMY
PLEASE ATTACH A COPY OF ALL THE DOCUMENT AND CERTIFICATE
SEA GOING EXPERIENCE
Vessel Name
Company
Type of Vessel
DWT or GRT
Type of Engines
Or DP System
BHP
Rank
Sign on Date
Sign off Date
MV INAI SELASIH
INAI KIARA SDN BHD
THSD
10338
(STORK WERKSPOOR 6TM 410)-WARTSILA
11834
ENGINE CADET
23/06/2010
27/09/2010
MV JM INDAH
JASA MERIN SDN BHD
SSV
1233
(CATERPILLAR
CAT 3606 DITA)
4640
ENGINE CADET
09/10/2010
09/01/2011
MV JM GAGAH 2
JASA MERIN SDN BHD
AHTS
1669
(YANMAR 6EY26)
5220
ENGINE CADET
28/02/2011
21/07/2011
MV NAUTICAL ALANYA
NAUTICAL RETURNS SDN BHD
AWB,MPSV
2770
(CUMMINS KTA 50M2)
3200
OILER
21/01/2014
07/04/2014
DSV ALLIED CENTURION
AME SERVICES SDN. BHD
DSV
(DP2)
2455
(WARTSILA VASA 614TK & 814TK)
3720
OILER
02/05/2014
04/09/2014
MV SEA EAGLE 1
DEEP SEA SUPPLY (M) PTE LTD
AHTS
(DP2)
2952
(WARTSILA 9L32 RATED)
12240
OILER
22/10/2014
27/01/2015
MV ARKSTAR EAGLE 3
ARKSTAR OFFSHORE PTE LTD
AHTS (DP1)
1373
( CATERPILLAR CAT 35168B-HD)
5150
OILER
14/06/2015
12/09/2015
MV NAUTICAL ALIYA
NAUTICAL RETURNS SDN. BHD.
AWB,MPSV DP2
6368
(NIIGATA 6L28AHX)
6000
OILER (A.S.E.)
23/01/2017
01/03/2017
MV JHW SAPPHIRE
JHW REELS SDN BHD
AHTS
1678
(CATTERPILLAR CAT 3516B)
5150
OILER (A.S.E.)
18/05/2017
18/07/2017
MV TOURMALINE
CHOFFSHORE PTE. LTD.
AHTS (DP2)
2442
4-STROKE (WARTSILA 9L32)
12240
OILER
(A.S.E.)
31/08/2017
19/11/2017
REFEREES (Two referees who are not member of immediate family)
Name
Position
Company
Contact Number
C/E AZAHAR BIN ISMAIL
CHIEF ENGINEER
INAI KIARA SDN BHD
+6019 -279 8037
CIK SURIANI
CREWING MANAGER
JASA MERIN SDN BHD
+609 - 851 1100
C/E EKO SUDARSONO
CHIEF ENGINEER
DEEP SEA SUPPLY PTE LTD
C/E MUHAMMAD SHAM
CHIEF ENGINEER
ARKSTAR OFFSHORE PTE. LTD.
C/E NUR AGUS KURNIANTO
CHIEF ENGINEER
JHW SAPPHIRE SDN BHD
+62-813-****-**** / +62-818-****-****
C/E ARTORN ARCHVAKHUN
CHIEF ENGINEER
CHOFFSHORE PTE. LTD.