PERSONAL APPLICATION FORM

Position applied for: OS

Personal data

Name

SHYJU M THARAKAN

Date of birth

**/**/****

Place of birth

KUNDARA

Nationality

INDIAN

Marital status

Married

Tel

904-***-****

Next of kin

Address

Charuvila puthen veedu,hospital jn kundara po kollam

Pre-sea education

MARINE TRRAINING ACADEMY Mumbai (Gp rating)

Document Date and place of issue Expiry date

Seaman’s book

Mum 2114478

07.02.2013 mumbai

06.02.2023

Passport

J 3631556

19.04.2011 trivandrum

18.04.2021

Medical certificate

Medical test

Height, cm: 173

Weight, kg: 79

Colour of Eyes: brown

Colour of Hair: Black

Size: XL

Shoes: 42-43

STCW Certificates

Name of institude

Certif.

Date of issue

Expiry date

Pre-sea course

M T A mumbai

1389/2013

23.01.2013

Endorsement

Fire prevention and fire fighting

Euro tech

63-13/000812

10.08.2013

09.08.2018

GMDSS (endorsement)

P S T

Euro tech

63-13/000815

10.08.2013

09.08.2018

A.R.P.A.

PSSR

Euro tech

842-13/013906

16.08.2013

unlimited

Familiarization with ISPScode

M T A mumbai

1493/2012

31.12.2012

Medical first aid

Medical care

Prof. in survival craft

Ship Safety Officer

Ship Security Officer

Elementary first aid

M T A mumbai

1252/2012

17.10.2012

Training for seafarers with designated security duties

Euro tech

70-13/001502

10.10.2013

unlimited

Additional courses attended (STCW Certificates)

Chemichal tanker

familiarisation

M T A mumbai

7845/2013

Basic training for oil and chemical tanker cargo operations

M T A mumbai

3693/2012

SEA SERVICE

From

To

Ship’s name

vessel type

Type of engine/BHP

Flag

Company

08.12.2014

02.06.2015

M/V Sealion

Supply vessel

Diesel/catterpillar

kuwait

A G M S

17.08.2015

18.12.2015

Shark 54

A H T S V

Diesel/catterpillar

kuwait

A G M S

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