Photograph
*. PERSONAL DETAILS
Surname : CHATURVEDI First Name : SURYANSH Middle Name :
Nationality : INDIAN Date of Birth : 25/08/1997 Place of Birth : LUCKNOW Weight (kg) : 82 Height (cm) : 175 BMI : 26.25
Post Applied for : TRAINEE MARINE ENGINEER
Permanent Address :
268/42,B.L,NIGAM LANE,CHITWAPUR KHAS,LUCKNOW,UTTAR PRADESH Pin Code- 226001
Nearest Airport: CHAUDHARY CHARAN SINGH,AMAUSI,LUCKNOW,UTTAR PRADESH Tel No / Mobile No: +91-790*******
Email ID: ********************@*****.***
INDIAN MARITIME UNIVERSITY
(A Central University, Govt. Of India)
MAEER’S MAHARASHTRA ACADEMY OF NAVAL
EDUCATION AND TRAINING (MANET), PUNE
2. PASSPORT DETAILS
Passport No.
Date of
Issue
Place of Issue Date of Exp. ECNR Blank Pages
R2529677 08/08/2017 LUCKNOW 07/08/2027 NR 32
3. CONTINUOUS DISCHARGE CERTIFICATE / INDOS
Seaman’s
Book (CDC)
Number Date of Issue Place of Issue Expiry Date Remark CDC MUM
382811
03/06/2019 MUMBAI 03/06/2029
INDOS 15EL1328 04/09/2015 INDIA
4. FAMILY INFORMATION
Full Name of Next of Kin : J.N.CHATURVEDI Relationship : FATHER Address of Next of Kin: 268/42,B.L,NIGAM LANE,CHITWAPUR KHAS
,LUCKNOW,UTTAR PRADESH.
Tel No. : 945-***-****
Family Data Name Occupation Contact Number/e-mail ID Father J.N.CHATURVEDI BUSINESSMAN 945-***-****
Mother PUNAM CHATURVEDI BUSINESSWOMAN 983-***-****
Brother/Sister
SHIVANSH CHATURVEDI STUDENT
Any Relatives in Marine Field – Acquaintance- Capt. Mukul Chaturvedi (TORM) 5. ACADEMIC QUALIFICATION
QUALIFICATION
YEAR OF
PASSING
PERCENTAGE
PCM
PERCENTAGE
BOARD / UNIVERSITY
B.TECH MARINE
ENGINEERING
2019
I.M.U
DIPLOMA
---
H.S.C.
2015 88% 81% I.S.C
S.S.C.
2013 77% - I.C.S.E
6. DETAILS OF B.TECH (MARINE) COURSE:
SEMESTER
PERCENTAGE AVERAGE %
SEMESTER 1 66.81 70.61
SEMESTER 2 67.63
SEMESTER 3 66.63
SEMESTER 4 68.18
SEMESTER 5 75.72
SEMESTER 6 72.2
SEMESTER 7 72.10
SEMESTER 8 ONBOARD TRAINING AND
ASSESSMENT
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
CMETL/BSST/010/290
21/07/2018
21/07/2023
LUCKNOW
CMET
Proficiency in Survival
Craft /
Rescue Boat / PST /
PSC RB Up gradation
CMETL/BSST/010/290
21/07/2018
21/07/2023
LUCKNOW
CMET
Elementary / Medical
First Aid / Medicare
CMETL/BSST/010/290
21/07/2018
21/07/2023
LUCKNOW
CMET
Personal Safety &
Social Responsibility
(PSSR)
CMETL/BSST/010/290
21/07/2018
21/07/2023
LUCKNOW
CMET
STSDSD CMETL/STSDSD/347/5407
24/07/2018
24/07/2023
LUCKNOW
CMET
BASIC TRAIING IN
OIL & CHEMICAL
TANKER CARGO
OPERTATIONS
1030080761907711 10/08/2019 UNLIMITED LUCKNOW HSNA HOBBBIES AND INTRESTS-
8. OTHER CERTIFICATES
Sr.No.
Details of the Certificates
1 INTER HOUSE VOLLEYBALL CHAMPIONSHIP
2 INTER HOUSE CHESSS CHAMPIONSHIP
3 NATIONAL LEVEL INTER-ENGINEERING SPORTS MEET(VOLLEYBALL) 4 NATIONAL LEVEL INTER-ENGINEERING SPORTS MEET(CHESS) 10. 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-15/08/2019 Name-SURYANSH CHATURVEDI Signature CHESS,CRICKET AND VOLLEY BALL