ENGINE APPLICATION FORM

POSITION APPLIED: *rd engineer DATE: September 4, 2023

PERSONAL INFORMATION:

Last Name: Dela Cruz First Name: Andronico Middle Name Gomez Address: Block 5 Lot 1 Tierra Nova Main Bagumbong Caloocan Religion: Catholic Email:ad1jcj@r.postjobfree.com Height: 5’6 Weight: 80 kgs. Civil Status: Married Date of birth: April 21 1969 Place of birth : Manila Age:53 Contact Number: 091********

Contact Information

Person to be notified in case of emergency: Eliza dela cruz Relationship: Wife Home Adresss: Block 5 Lot 1 Tierra Nova Main Bagumbong Caloocan Mobile: 093******** Email : ad1jcj@r.postjobfree.com Government ID Number:

SSS# : 039******* TIN: 126521547

SEAMANSHIP DOCUMENTS/LICENSES:

NUMBER ISSUE EXPIRY

SIRB No. C1197233 Dec 18, 2017 Dec 16, 2027

S.R.C. 028263496 Nov 9, 2016

Passport No. P766059B Sept 22, 2021 Sept 21, 2031

Yellow Fever Vaccine QG034777 Oct 29, 2013 OCT 2023 Current License E30014600

COC Regulation &

Capacity

OICEW200002694521 August 19 2021 August 19 2026

Marshall Island 39-29301 Nov 10, 2022

EDUCATIONAL BACKGROUND:

COLLEGE:

Name of School: Philippine Maritime Academy

Course : Associate Marime Engineering

Year Attended : October 1988

HIGHSCHOOL

Name of School: President Sergio Osmeña

Year Attended : 1986

COC AND TRAINING CERTIFICATES:

TRAINING NO/ ISSUE DATE TRAINING CENTER

ATFF 057-********-AM 7-23-21 FAR EAST MARITIME

BT 057-********-AM 7-8-21 FAR EAST MARITIME

PSCRB 072-********-AM 7-16-21 FAR EAST MARITIME

MEFA / NAC 18-52596/ 11-10-2016 Marina

MARPOL I MPI-VI-13-0904740 PNTC College

MARPOL II MPI-VI-13-0904740 PNTC College

MARPOL III MPI-VI-13-0904740 PNTC College

MARPOL IV MPI-VI-13-0904740 PNTC College

MARPOL V MPI-VI-13-0904740 PNTC College

MARPOL VI MPI-VI-13-0904740 PNTC College

4 Stroke Diesel/Turbine 98200848 Far East Maritime BTOC BL-BTOC-210399257

6-12-21

EXACT

EMPLOYMENT HISTORY (PAST TO PRESENT):

COMPANY VESSEL

NAME

VESSEL

TYPE

POSITION FROM

(M/D/Y)

TO

(M/D/Y)

# OF

MONTHS

CAUSE OF

DISCHARGE

SEA

TRADE

M/Y

CAMILLA

YAHCT CHIEF

ENG

03-01-

2023

08-12-

2023

5 VACATION

TRAWIND MV TIAN

PENG

BULK 3RD ENG 02-14-2

022

11-24-2

022

9 VACATION

MORETA MV

ACHIEVER

CONTAINER 3RD ENG 11-11-20

21

1-7-202

2

2 VACATION

ALSEER TOPAZ YAHCT 3RD ENG 08-14-2

018

10-10-2

018

2 CHANGE

OWNER

NURAI TOPAZ YAHCT 3RD ENG 01-03-2

018

05-07-2

018

5 VACATION

Q MIRI YAHCT 3RD ENG 06-06-2

017

10-04-2

017

5 VACATION

Q MIRI YAHCT 3RD ENG 11-28-2

016

04-10-2

017

5 VACATION

Q MIRI YAHCT 3RD ENG 07-18-2

016

10-15-2

016

4 VACATION

Q MIRI YAHCT 3RD ENG 06-16-2

015

05-29-2

016

11 VACATION

DELMA YAHCT 3RD ENG 11-15-2

013

11-29-2

014

12 VACATION

DELMA YAHCT 3RD ENG 03-06-2

012

09-05-2

013

18 VACATION

DELMA YAHCT 3RD ENG 06-27-

2010

10-20-2

011

16 VACATION

DELMA YAHCT 3RD ENG 05-15-2

009

03-18-2

010

10 VACATION

DELMA YAHCT 3RD ENG 05-23-2

008

03-18-2

009

10 VACATION

ALYSIA YACHT 3rd ENG 05-04-0

6

07-07-2

007

15 VACATION

M/V MANNA BULK 4th ENG 26-07-0

5

25-10-0

5

3 VESSEL

SOLD

M/V SEA JOY BULK 4th ENG 24-09-0

3

04-10-0

4

12 VACATION

M/V PRETTY

LADY

BULK 4thENG 18-10-0

1

03-04-0

3

23 VACATION

M/V

AMARANTOS

BULK 4thENG 24-01-9

9

27-08-9

9

8 VACATION

M/V ALEXIA BULK 4thENG 19-11-9

7

19-09-9

8

11 VACATION

M/V

POTAITISSA

BULK 4thENG 02-05-9

6

28-08-9

6

3 VESSEL

SOLD

M/V

GEORGIOS P

BULK OILER 01-10-9

4

13-10-9

5

12 VACATION

DUTIES AND RESPONSIBILITIES

NAME OF VESSEL LENGTH DESCRIPTION OF JOB

ON BOARD

DELMA 2008 to 2015 MAINTAINING ALL

MACHINERIES

ENGINE RATING AND OFFICER SKILLS:

YES NO

I can operate a jet ski

I can operate a tender

I can operate a crane

I have knowledge in refrigeration

I have knowledge in air-conditioning

I have gas welding knowledge

I have mechanical knowledge

I have knowledge in hydraulics

I have knowledge in water maker systems

I have knowledge in electrical systems

I get seasick

ON BOARD REFERENCES:

NAME RANK/VESSEL

NAME

EMAIL ADDRESS CONTACT

NUMBER

r Chief Engineer

M/Y Marayha

ad1jcj@r.postjobfree.com +385********

Rumesh Hiranth Chief Engineer ad1jcj@r.postjobfree.com *614******** Andronico Dela Cruz

SIGNATURE OVER PRINTED NAME

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