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: adaalf@r.postjobfree.com

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

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