PERSONAL DESCRIPTION AND INFORMATION
Name - HARSH Middle Last GOYAL
First : : :
(As per Passport)
Date of 10/10/1993 Place (City and AGRA, INDIA Nationali INDIAN
Birth : Country) : ty :
Passport K8075756 Place of GHAZIABAD Issue 10/12/ Expiry 09/12/2
No.: Issue : Date : 12 Date : 2
U.S.VISA - Place of Issue Expiry
Type : Issue : Date : Date :
Permanent 112 SHANTI NAGAR, MUGHAL ROAD, KAMLA NAGAR AGRA
Address :
Phone - STD No.
Code : :
Fax Mobile +91-752******* E-Mail **********.****@*****.***
No. : No. : :
Nearest Airport / INDIRA GANDHI INTERNATIONAL AIRPORT/ DELHI
Railway Station :
Present 112 SHANTI NAGAR, MUGHAL ROAD, KAMLA NAGAR AGRA
Address :
Phone - STD No.
Code : :
Fax Mobile +917********* E-Mail **********.****@*****.***
No. : No. : :
Civil Status : SINGLE No. of
Children :
Next of UTKARSH BANSAL Relatio BROTHER
kin : n :
Address of next 02 RAM KUNJ, VIMAL VATIKA, KARMYOGI ENCLAVE, KAMLA NAGAR AGRA
of kin : (U.P)
Phone - STD 0562 No. 2884821
Code : :
Fax Mobile +917********* E-Mail **********.****@*****.***
No. : No. : :
Emergency Address (if family 10/703, SEAWOODS ESTATE, NERUL, NEW MUMBAI.
is on board) :
Phone - STD 022 No. 39610073
Code : :
Fax Mobile +91-981******* E-Mail **********.****@*****.***
No. : No. : :
Name of Father and Mother DOB RELATION AGE
SUDHIR GOYAL 01/01/195 FATHER 55
8
PRIYA GOYAL 02/2/63 MOTHER 50
Position applied DECK CADET Date of
for : Availability :
Courses / Certificates Number Date of Date of Place of
Issue Expiry Issue
ELEMENTRY FIRST AID . 3021 16/07/2 CHENNAI
012
FIRE FIGHTING AND FIRE PREVENTION. 3040 08/07/2 CHENNAI
012
PERSONAL SURVIVAL TECHNIQES. 3566 18/07/2 CHENNAI
012
CERTIFICATE OF PROFICIENCY IN SECURITY 47 04/12/2 UNLIMITED CHENNAI
TRAING FOR SEAFARERS WITH DESIGNATED 012
SECURITY DUTIES.
PERSONAL SAFETY AND SOCIAL 4749 11/07/2 CHENNAI
RESPONSIBILITES. 012
OIL TANKER FAMILIARIZATION. 1201 08/01/2 CHENNAI
013
CHEMICAL TANKER FAMILIARIZATION BPMA/CTFC/948/20 13/12/2 MUMBAI
13 013
OIL TANKER FAMILIARIZATION ENDORSEMENT D/C/1/D/13/18394 18/12/2 NOIDA
013
CHEMICAL TANKER FAMILIARIZATION D/C/1/D/13/18395 18/12/2 NOIDA
ENDORSEMENT 013
Tanker Safety (Specialised) Petroleum
Chemical
LPG
Dangerous Cargo Endorsement Petroleum
Chemical
OIL
Radio Telephony / RMC / MCC
GMDSS (INDIAN / AUSTRALIAN)
U.K.
PANAMA
BAHAMAS
NORWAY
VANUATU
Radar Observers Course
ARPA
Radar, ARPA & Navigation Simulator
Radar Simulator / ENS
Engine Room Simulator
Ship Handling Simulator
Liquid Cargo Handling
Simulator
HAZMAT
OPA 90 / VRP/ Pollution Management
Computer Familiarisation (AMOS - D, etc.)
Safety Management System Familiarisation
Ship Manoeuring & Bridge Team work (B T
M)
Bridge Resource Management
FRAMO / High Pressure Hydraulic Systems
Crew Resource Management
Watch Keeping Course (Deck / Engine)
English Language Training (Marlin's
English Test)
Watch Keeping for Ratings
Liberian Special Qualifications
Basic Training
Survival Craft Crewman
Advanced Fire Fighting
Tankerman (Person - In - Charge)
Operational / Management Level
Tankerman (Person Assisting) Support
Level
Pumpman / Bosun / AB / OS / Oiler / Wiper
Norwegian Mustering Book (Yellow Book)
YELLOW FEVER VACCINATION 00738 10/02/2 09/02/202 MUMBAI
014 4
CDC NO. MUM 215724 10/05/2 09/05/202 MUMBAI
013 3
INDOS No. 12NL2193 28/09/2 MUMBAI
012
ISO 9001:2000 QMS DNV
Details of any courses / certificates not included in the above to be specified in free
space or unutilised columns.
SCHOOLS ATTENDED (including Pre Sea Training)
Name of School
Town / Country
From
To
Type of Degree / Diploma received
ESS ESS CONVENT SCHOOL
AGRA
2007
2008
SSC
ESS ESS CONVENT SCHOOL
AGRA
2009
2010
HSC
LANGUAGES (F : Fluent - M : Moderate)
Spoken Written Read Others Spoken Written Read
(specify)
English F F F
Hindi F F F
PHYSICAL DECLARATION
Height 167 cm Weight kg Colour of BLACK Colour of BLACK
: : Hair : Eyes :
VISION Excellent Good Poor
Without glasses YES
With glasses
HEARING Normal Poor Nil
Right Ear YES
Left Ear YES
Date : Rank : DECK CADET
Signature : HARSH GOYAL