Application for Sea Personnel

Application For Employment As : Engine Cadet

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F A M I L Y

Surname: Baranowski

First Name: Bartłomiej

Middle Name: Kacper

Nationality: Polish

Date of Birth: 04.09.1995

Place of Birth: Lębork

Marital Status: single

Name of Spouse:

Permanent Address:

ul. Krótka12, 84-223 Linia

Poland

Height: 182 Weight: 90

Telephone No.

+48-538******

Email address:

aczabw@r.postjobfree.com

Passport No. EF 1805038

Place of Issue: Lębork

Date of Issue 05.08.2013

Date of Expiry: 05.08.2023

Seaman’s Book No. 0275486

Date of Issue 2016.01.15

Place of issue : Gdynia

Nearest International Airport: Gdańsk

US VISA

Date of Issue:

Date of expiry:

Shengen Visa

Date of Issue:

Date of expiry:

Medical examination

Date of Issue: 10.12.2015

Date of expiry: 10.12.2017

Vaccination Yellow Fever

Date of Issue:

Date of expiry:

Drug and Alcohol test

Date of Issue:

Result:

EMERGENCY

Next of Kin: Dorota Baranowska

Address: ul. Krótka12, 84-223 Linia

Poland

Relationship: Mother

Telephone No.:

Mob: +48-691******

Telephone No.:

Office:

ESTABLISHMENT Name (Nautical College / Institute)

Date Attended

Gdynia Maritime University

2014

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LICENCE PARTICULARS

Cert No

Date / Place of Issue

Validity

National Certificate of Competency

Other:

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S T C W 95 QUALIFICATION

Type of Certificate

Ref No

Date / Place of Issue

Expire date

Personal Survival

GUM-5425-139254-36055/2015

2015.12.14 Gdynia

2020.12.14

Elementary First Aid

GUM-5425-139254-36055/2015

2015.12.14 Gdynia

2020.12.14

Fire Fighting

GUM-5425-139254-36055/2015

2015.12.14 Gdynia

2020.12.14

Personal Safety / Responsibility

GUM-5425-139254-36055/2015

2015.12.14 Gdynia

2020.12.14

Proficiency in Security-awareness

GUM-1350-139254-37128/2015

2015.12.22 Gdynia

Valid indefinitely

Proficiency for seafarers with designated security duties

GUM-1351-139254-74490/2016

2016.11.25 Gdynia

Valid indefinitely

Training in Liquified Gas Tanker Familiarization

GUM-1303-139254-71862/2016

2016.11.17 Gdynia

Valid indefinitely

Training in Oil and Chemical Tanker Familiarization

GUM-1337-139254-71891/2016

2016.11.17 Gdynia

Valid indefinitely

Survival Craft & Rescue Boats

Advanced Fire Fighting

Medical First Aid

ARPA

GMDSS / GOC

ECDIS

Ships Safety Officer

HAZMAT

HUET

BOSSIET

DP courses :

Name of Vessel

Flag

Type of

Vessel

and Engine

(Type)

HP

Rank

Period of Service

Name of Owners,

Crew Agent

( Their Contact details),

Remarks

s/v Dar Młodzieży

Polish

School sailing / frigate

1500

Engine cadet

27.01.2016

26.03.2016

AM Gdynia

Contact this candidate