RANK APPLIED

Trainee Marine Engineer

INDOS NUMBER

17EL1875

1. PERSONAL DETAILS SURNAME FIRST NAME MIDDLE NAME

NAME

SURIN

AJAY

KUMAR

Date of Birth

**/**/****

Place of Birth

KAPURTHALA

Nationality

INDIAN

Permanent Address

RAJABASA

GUTBAHAR, SIMDEGA

PIN: 835223, JHARKHAND, INDIA

Present Address

438-B TYPE-2

RAIL COACH FACTORY, KAPURTHALA PIN:144602, PUNJAB,INDIA

City & Pin Code : SIMDEGA - 835223

City & Pin Code : KAPURTHALA - 144602

Mobile No. : 946-***-****

E- mail : ac9s61@r.postjobfree.com

2. NEXT OF KIN / FAMILY PARTICULARS

NAME / RELATION

MANJULA HORO / MOTHER

ADDRESS

RAJABASA

GUTBAHAR, SIMDEGA

PIN: 835223, JHARKHAND, INDIA

3. PASSPORT DETAILS

NUMBER

PLACE OF ISSUE

DATE OF ISSUE

DATE OF EXPIRY

PASSPORT

P9972423

RANCHI

30/06/2017

29/06/2027

4. CONTINUOUS DISCHARGE CERTIFICATES

CDC

NUMBER

PLACE OF ISSUE

DATE OF ISSUE

DATE OF EXPIRY

INDIAN

KOL107399

KOLKATA

21/05/2018

20/05/2028

5. ACADEMIC QUALIFICATIONS Grade / Degree From(Year) To (Year)

SCHOOL

KV RCF

SSLC - 65%

2007

2008

SCHOOL

PRIVATE CANDIDATE

HSC - 56%

2010

2011

COLLEGE

SLIET

DIPLOMA- 71%

2011

2013

COLLEGE

ACEM

B.E -MECH – 72%

2013

2016

PRE- SEA TRAINING

INSTITUTE

COCHIN SHIPYARD LTD (METI)

GME – 62%

2017

2018

6. STCW AND OTHER CERTIFICATES

STCW Courses

Certificate No.

Date of Issue

Date of Expiry

Place of Issue

Issuing Authority/ INSTITUTE

PSSR

PSSR/EMA/1183-18/020095

18/01/2018

UNLIMITED

KOCHI

EURO TECH MARITIME ACADEMY

EFA

EFA/1485/2018

17/02/2018

UNLIMITED

KOCHI

COCHIN SHIPYARD LIMITED

PST(Survival)

PST/EMA/1178-18/019318

07/03/2018

UNLIMITED

KOCHI

EURO TECH MARITIME ACADEMY

FP & FF

(First Fighting)

FPFF/5823/2018

19/01/2018

UNLIMITED

KOCHI

COCHIN SHIPYARD LIMITED

STSDSD

METI/STS/2559

24/01/2018

UNLIMITED

KOCHI

COCHIN SHIPYARD LIMITED

SIMULATOR TRAINING

ENGINE SIMULATOR

SOL/143/1520

28/02/2018

UNLIMITED

KOCHI

KUNJALI MARAKKAR SCHOOL OF MARINE ENGINEERING

TANKER COURSES

GAS TANKER FAMILIARISATION

201************

30/11/2018

UNLIMITED

MUMBAI

MARITIME TRAINING INSTITUTE

(SCI)

TANKER (OIL, CHEMICAL COMBINED)

201***********

07/12/2018

UNLIMITED

MUMBAI

MARITIME TRAINING INSTITUTE (SCI)

OTHER COURSES

AUGFF

TFFC/171/2018

25/01/2018

UNLIMITED

KOCHI

COCHIN SHIPYARD LIMITED

7. DECLARATION

I declare that the information given above is complete and true to the best of my knowledge. I also declare that the documents submitted are genuine, given and signed by the persons whose names appear on them. Any false declaration may render me liable for termination or dismissal

Date: SIGNATURE OF APPLICANT:

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