*. PERSONAL DETAILS
Surname : Khairnar
First Name : Tejaskumar
Middle Name : Nanabhau
Nationality : Indian
Date of Birth : 18/04/1992
Place of Birth : Nashik
Weight (kg) : 72kg
Height (cm) : 176cm
BMI :
Post Applied for :
Junior Engineer
Permanent Address : 13, chitrakut coloney, phophale mala, sangamner. Dist:Ahamadnagar. State:Maharashtra.
Present Address : Gat.No.140. Loni Kalbhor, Rajbag, pune.
PIN Code:422605
Nearest Airport: pune
PIN Code: 412201
Tel No / Mobile No: +917*********
Tel No / Mobile No: +917*********
Email ID: *************@*****.***
2. PASSPORT DETAILS
Passport No.
Date of Issue
Place of Issue
Date of Exp.
ECNR
Blank Pages
M5393047
08/01/2015
PUNE
07/01/2025
36
3. CONTINUOUS DISCHARGE CERTIFICATE / INDOS
Seaman’s Book (CDC)
Number
Date of Issue
Place of Issue
Expiry Date
Remark
Indian
INDOS
13EL1027
24-JULY-2013
MUMBAI
4. FAMILY INFORMATION
Full Name of Next of Kin : Khairnar Nanabhau Pandurang
Relationship : Father
Address of Next of Kin: 13, chitrakut coloney, phophale mala,sangamner, dist: Ahamadnagar, state: Maharashtra.
Tel No. : +919*********
Family Data
Name
Occupation
Contact Number/e-mail ID
Father
Mr. Khairnar Nanabhau Pandurang
gov.servent
Mother
Mrs. Khairnar Sunanda Nanabhau
housewife
Brother/Sister
Miss. Khairnar Tejashree Nanabhau
education
Any Relatives in Marine Field - Yes, Brother-in-low (Mr. Vaibhav Wake-Chief engineer, Anglo-Estern)
5. ACADEMIC QUALIFICATION
QUALIFICATION
YEAR OF PASSING
PERCENTAGE
PCM
PERCENTAGE
BOARD / UNIVERSITY
B.TECH MARINE
2016
64.57
Y.C.M.O.U
DIPLOMA
2013
70.33
M.S.B.T.E. Mumbai
S.S.C.
2007
68.30
Maharashtra Board
6. DETAILS OF B.TECH (MARINE) COURSE:
SEMESTER
PERCENTAGE
AVERAGE %
SEMESTER 1
exemption
64.57
SEMESTER 2
exemption
SEMESTER 3
66.85
SEMESTER 4
66.43
SEMESTER 5
65.43
SEMESTER 6
60.14
SEMESTER 7
64.00
SEMESTER 8
7. STCW AND OTHER COURSES
Details of Courses & Certificates
Number
Dt. Of Issue
Dt. Of Expiry
Pl. of Issue
Issued by
Advanced / Basic Fire Fighting
F394B6169CBA287F
10/01/2015
UNLIMITED
MUMBAI
NAMAC
Proficiency in Survival Craft / Rescue Boat / PST / PSC RB Up gradation
5E152B949F0C3284
10/01/2015
UNLIMITED
MUMBAI
NAMAC
Elementary / Medical First Aid / Medicare
MANET/EFA/01/011
02/07/2014
01/07/2019
PUNE
MANET
Personal Safety & Social Responsibility (PSSR)
MANET/PSSR/02/011
05/07/2014
04/07/2019
PUNE
MANET
Security Training For Seafarers with Designated Security Duties(STSDSD)
BPMA/STS/2158/2015
10/11/2015
UNLIMITED
MUMBAI
BPMA
8. OTHER CERTIFICATES
Sr.No.
Details of the Certificates
1.
National level Football Certificate
2.
State level Handball certificate (played 3 times)
3.
District level Handball certificate (played 3 times with 1st rank)
4.
State level Robowar certificate
5.
State level Roborace certificate with 1st rank
9. 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 Khairnar Tejaskumar N. Signature