Seafarer Profile
Last updated date : 24/06/2013 12:04 PM Date :
: Nautical
Personal Details
Name
Gender
Date of Birth Place of Birth
Birth State Birth Country
Nationality
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ALLWYN ANTONY BEN VALIAVEETIL ANTONY
MALE
13/04/1992 ERNAKULAM
KERALA INDIA
INDIAN
10NL3447
VALIAVEETIL HOUSE
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City
State
City
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Pin
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Pin
Address
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Address : :
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Address Details
Present Address Permanent Address
EZHILODE P O
KUNHIMANGALAM
KANNUR
: 670309
KERALA State :
EZHILODE P O
KUNHIMANGALAM
670309
KERALA
VALIAVEETIL HOUSE
Country :
Telephone No. :
Country :
Telephone No. :
Mobile No. :
Email Id :
INDIA
******.******@*****.***
Physical Details
Hair Color
Eye Color :
Height (in Cms) :
: Complexion
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Identification : A WOUND SCAR NEAR THE NOSE
168
BLACK
BLACK
FAIR
INDoS No. : Discipline
Report generated on : 24/06/2013 11.41 AM Page 1 of 4 Education Details
Name of Institution
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Main Subjects :
Year of Passing :
English Mark :
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Institute Address :
PHYSICS,CHEMISTRY,MATHS
83
GHSS KUNHIMANGALAM
STATE
GHSS KUNHIMANGALAM, KUNHIMANGALAM PO
1 . 10TH (Matriculation/SSC)
Certificate No.
Education Level :
Name of University
PCM Mark Result /Grade
Name of Institution
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Main Subjects :
Year of Passing :
English Mark :
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Institute Address :
PHYSICS,CHEMISTRY,MATHS
HSE A503063 2009
65
GHSS KUNHIMANGALAM
STATE
GHSS KUNHIMANGALAM, KUNHIMANGALAM PO
2 . 10+2 (HSC/Intermediate/equivalent)
Certificate No.
Education Level :
Name of University
PCM Mark Result /Grade
Total no of record in Education Details : 2
Pre Sea Training Detail
Attended From (Date)
Certificate No.
Pre Sea Tar Book No.
Attended To (Date)
Result
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02/08/2010 03/08/2011
PSCADET/EMA/416 75%
Training Institute
Training Institute (other)
Euro Tech Maritime Academy (COCHIN)
Course Name Diploma in Nautical Science(IMU)
Modular Course Details
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Personal Survival Techniques
A-VI/1-1
03/01/2011
PST/EMA/619-11/10151
05/01/2011
Euro Tech Maritime Academy (COCHIN)
05/01/2011
1 . Course Name Personal Survival Techniques
Course Name
Report generated on : 24/06/2013 11.41 AM Page 2 of 4 Modular Course Details
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Personal Safety & Social Responsibilities
A-VI/1-4
06/01/2011
PSSR/EMA/618-11/9952
08/01/2011
Euro Tech Maritime Academy (COCHIN)
08/01/2011
2 . Course Name Personal Safety & Social Responsibilities Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Elementary First Aid
A-VI/1-3
10/01/2011
EFA/EMA/649-11/9740
12/01/2011
Euro Tech Maritime Academy (COCHIN)
12/01/2011
3 . Course Name Elementary First Aid
Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Fire Prevention & Fire Fighting
A-VI/1-2
13/01/2011
FPFF/EMA/575-11/9466
15/01/2011
Euro Tech Maritime Academy (COCHIN)
15/01/2011
4 . Course Name Fire Prevention & Fire Fighting
Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Tanker Familiarization- Oil
20/11/2012
OTF/EMA/129-12/001924
24/11/2012
Euro Tech Maritime Academy (COCHIN)
24/11/2012
5 . Course Name Tanker Familiarization- Oil
Course Name
Total no of record in Modular Course 5
Authorised Documents
1 . Document Type : CDC
Document Type : CDC
Document Number :
Valid Upto :
Issued Date :
Issued At :
MUM 188699 06/06/2011
05/06/2021 MUMBAI
Report generated on : 24/06/2013 11.41 AM Page 3 of 4 Total no of record in Authorised Documents : 1
I hereby declare that the particulars entered in the form are correct and true to the best of my knowledge and belief and that the papers enumerated in this form are true and genuine documents given and signed by the person whose names appears on them. I further declare that Seagoing service information entered is a true and correct account of my sea-going service without exception and I make this declaration conscientiously believing the same to be true. The documents in original will be presented to the examiner at the time of taking oral examination or at an earlier time when asked by the department. DECLARATION TO BE MADE BY CANDIDATE :
Date :
Signature of the candidate
This is an electronically generated document hence it does not require any signature of DGS Officials. Report generated on : 24/06/2013 11.41 AM Page 4 of 4