APPLICATION FORM

**.SECTION ONE: PERSONAL DETAIL

AVAILABILITY

ANY TIME

RANK

WIPER\OILER

NAME

KULBIR SINGH

NATIONALITY

INDIAN

MARITAL STATUS

UNMARRIED

DATE OF BIRTH

**/**/****

LANGUAGE KNOWN

ENGLISH,HINDI & PUNJABI

CONTACT NO / ALTERNATE CONTACT

NO

+917*********

EMAIL ID

ad2exr@r.postjobfree.com

PRESENT ADDRESS

VPO- FATEHPUR, P.O –SARAN DIST.-YAMUNA NAGAR HARYANA

133103 INDIA

PERMANENT ADDRESS

VPO-FATEHPUR, P.O –SARAN DIST.-YAMUNA NAGAR HARYANA

133103 INDIA

SAFETY SHOES

7

COVER ALL

L

02.SECTION TWO: DOCUMENTS HELD

DOCUMENTS

NO.

DATE OF ISSUE

DATE OF EXPIRE

PLACE OF ISSUE

PASSPORT

V1520614

05/08/2021

04/08/2031

CHANDIGARH

SEAMAN BOOK

MUM409621

03/02/2020

02/02/2030

MUMBAI

WATCH KEEPING

WKE21003416

07/06/2021

UNLIMITED

MUMBAI

INDOS NO

19GM0653

LIFE TIME

MUMBAI

YELLOW FEVER

210

25/08/2020

LIFETIME

DELHI

SID

M32191832

21/03/2022

20/03/2032

MUMBAI

03.SECTION THREE: S.T.C.W. COURSE

COURSES

CERTI. NO.

DATE OF ISSUE

PLACE OF ISSUE

GP RATING

G1912D03037

24/01/2020

DELHI

PRE SEA TRAINING

PSGPR1010050011903542

21/12/2019

DELHI

P.S.S.R

1010053071902216

19/07/2019

DELHI

S.T.S.D.S.D.

1010051481903213

23/07/2019

DELHI

E.F.A

1010053071902216

19/07/2019

DELHI

F.P.F.F

1010053071902216

19/07/2019

DELHI

P.S.T

1010053071902216

19/07/2019

DELHI

B.T.O.C.T.C.O

COPDGSOAC23108774

03/08/2023

MUMBAI

04.SECTION FOUR: SEA EXPERIENCE

VESSEL

COMPANY NAME

RANK

TYPE

GRT

SIGN ON

SIGN OFF

MV BLUE LOTUS

VIETFRACHT

TR.WIPER

BULK

CARRIER

8481

26/09/202

0

04/01/2021

MV GRAND FERRY

KARANEH LINES

WIPER

ROPAX

20805

09/08/202

2

11/7/2023

DATE: 23/12/2022 PLACE: MUMBAI

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