*. PERSONAL DETAILS
Surname :YADAV First Name :VIVEK Middle Name :
Nationality :INDIAN Date of Birth :02/03/1996 Place of Birth :CHHINDWARA
Weight (kg) :67 Height (cm) :184 BMI :
Post Applied for : DECK CADET
PERMANENT ADDRESS-AT-Naulajhir PRESENT ADDRESS--AT-Naulajhir
Post-Chand,Teh-Chand,Dist-Chhindwara,MP Post-Chand,Teh-Chand,Dist-Chhindwara,MP
Pincode-480110 Pincode-480110
Nearest Airport-
2. PASSPORT DETAILS
Passport No. Date of Place of Issue Date of Exp. ECNR Blank Pages
Issue
P0121978 03/08/2016 BHOPAL 02/08/2026 32
3. CONTINUOUS DISCHARGE CERTIFICATE / INDOS
Seaman's Number Date of Issue Place of Expiry Date Remark
Book (CDC) Issue
Indian
INDOS 15NL0884 28/08/2015 MUMBAI
4. FAMILY INFORMATION
Full Name of Next of Kin :BANWARI LAL YADAV Relationship : FATHER
Address of Next of Kin-AT-Naulajhir Tel No. :845-***-****
Post-Chand,Teh-Chand,Dist-Chhindwara,MP.Pincode-480110
Family Data Name Occupation Contact Number/e-mail
ID
Father BANWARI LAL YADAV FARMER 845-***-****
Mother SANJU YADAV HOUSE WIFE 845-***-****
SHARAD YADAV STUDENT 975-***-****
Brother/Sis
ter
Any Relatives in Marine Field -NONE
5. ACADEMIC QUALIFICATION
QUALIFICATION
YEAR OF PERCENTAGE PCM BOARD / UNIVERSITY
PASSING PERCENTAGE
2018 78.5% MIT-ADT UNVERSITY
B.SC. NAUTICAL
SCIENCE
DIPLOMA
2014 79.3% 79.3% CBSE
H.S.C.
2012 79.8% CBSE
S.S.C.
6. DETAILS OF B.TECH (MARINE) COURSE:
PERCENTAGE AVERAGE %
SEMESTER
SEMESTER 1 85.6%
78.5%
SEMESTER 2 75.2%
SEMESTER 3 78.2%
SEMESTER 4 72.5%
SEMESTER 5 75.1%
SEMESTER 6 84.6%
7. STCW AND OTHER COURSES
Number Dt. Of Dt. Of Pl. of Issued by
Details of Issue Expiry Issue
Courses &
Certificates
FIRE PREVENTION FPFF0301724414 17/06/201 KOLKATA
AND FIRE FIGHTING 7 MERCANTILE
MARINE ACADEMY
PERSONAL SURVIVAL PST0241714623 24/06/201 KOLKATA MERCANTILE
TECHNIQUES 7 MARINE ACADEMY
Elementary / MANET/EFA/33/2016/00 02/07/201 01/07/202 PUNE MANET,PUNE
Medical First Aid 5 6 1
/ Medicare
Personal Safety & MANET/PSSR/31/2016/0 29/06/201 PUNE MANET,PUNE
Social 05 6 28/06/202
Responsibility 1
(PSSR)
Security Training STS0631700005 20/06/201 KOLKATA MERCANTILE
for Seafarers 7 MARINE ACADEMY
with Designated
Security Duties
HOBBBIES AND INTRESTS-
8. OTHER CERTIFICATES
Sr.No. Details of the Certificates
1 CERTIFICATE OF PARTICIPATION ON TRAINING PROGRAM ON SOFT SKILLS
2 REGIONAL LEVEL BASKETBALL MEET CERTIFICATE
3 PRE-SENIOR UN INFORMATION TEST CERTIFICATE
9. DANGEROUS CARGO ENDORSEMENTS
Grade / Number Date of Place of Date Of
Dangerous Cargo Level Issue Issue Expiry
Endorsements I / II
10. 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 / / Name
Signature
[pic][pic]
[pic] [pic]
MIT GROUP OF INSTITUTIONS PUNE
MAHARASHTRA ACADEMY OF NAVAL EDUCATION
& TRAINING [MANET]
Gat No.140, Loni-Kalbhor, Rajbaug, Pune-Solapur Highway,
Pune-412201.
Photograph
PLAYING BASKETBALL,READING BOOK
.
1.