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Medical Engineer

Location:
Mansoura, Dakahlia Governorate, Egypt
Salary:
1600
Posted:
January 13, 2020

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Resume:

APPLICATION FORM

NOTES FOR APPLICATION FORM COMPLETION:

- Please ensure that the below application form is completed in word format.

- Once completed, please fill declaration box on last page and return form to us in word format only.

SECTION 1- SEAFARER PERSONAL DETAILS AND POSITION APPLIED FOR

Position applied for:

2nd officer or 3rd officer

Expected Day Rate:

According to the company

Date of availability (dd/mm/yyyy):

20/10/2019

Family name:

Zayeda

First name(s):

Moustafa

Date of birth (dd/mm/yyyy):

01/07/1987

Place of birth:

El – menofia

Nationality:

Egyptian

Full permanent address:

El – masoura city –mubarak city – 40 el mostasharen street bulding no.40 flor no 3

Full present address

(if different):

Kafe helal berket el sabaa el menofia – Egypt

Nearest airport:

Cairo International Airport

Airport distance from address (km):

100 km

Email address:

adbaoc@r.postjobfree.com

Contact number:

+205********

Skype address:

Mobile phone number:

+201*********

Blood group:

O+

Positive / Negative:

+

Height:

181

Weight:

100

PPE Safety shoe size:

45

PPE coverall size:

Xxl

SECTION 2-SEAFARER PASSPORT, SEAMAN BOOKAND VISA DETAILS

Document details

Document number

Country of issue

Date of issue

Date of expiry

Primary Passport:

A23297775

A23297775

17/09/2018

16/09/2025

Second Passport

(if applicable):

Seaman book:

211327

Egypt

28/08/2018

05/10/2022

Flag Seaman book (if any):

USA Visa Type (if held):

USA Visa expiry:

Additional Visa (country):

Visa expiry:

SECTION 3- NEXT OF KIN

Full name:

Israa el Sayed Yosef heiba

Relationship to Seafarer:

My wife

Full address:

El – Mansoura city –Mubarak city – 40 el mostasharen street building no.40 floor no 3

Contact number:

+205********

Email address:

adbaoc@r.postjobfree.com

Mobile phone number:

+201*********

SECTION 4- HIGHEST CERTIFICATE OF COMPETENCY/LICENCE/CRANE OPERATORS CERTIFICATES/OTHER EQUIVALENT CERTIFICATES AND FLAG STATE ENDORSEMENTS (STCW2010 / STCW78 AS AMENDED)

Class / Grade / Capacity

Issuing country

Certificate number

Date of issue

Date of expiry

Details of any limitations

COC

Egypt

11194

16/08/2018

05/10/2022

No limitations

GOC

Egypt

31588

14/12/2018

02/12/2023

No limitations

SECTION 5- STCW2010 (STCW78 AS AMENDED)

CERTIFICATION AND RELATED COURSES

Name of Course / Certificate

STCW Code

Certificate number

Date of issue

Place of issue

Date of expiry

Prevention marine pollution

I / II & III / 2

21976/18/EG.

26/07/2018

EGYPT

XXXXXXXXXX

communications

A-VI / 1

21910/18/EG.

26/07/2018

EGYPT

XXXXXXXXXX

Personal safety and social

A-VI / 1

37642/17/EG.

29/10/2017

EGYPT

25/10/2022

Personal survival techniques

A-VI / 1-1

35152/17/EG.

11/10/2017

EGYPT

09/10/2022

Fire prevention & fire fighting

A-VI / 1-2

Elementary first aid

A-VI / 1-3

Personal safety & social responsibility

A-VI / 1-4

37642/17/EG.

29/10/2017

EGYPT

25/10/2022

Proficiency in survival craft & rescue boats

A-VI / 2-1

34631/17/EG.

08/10/2017

EGYPT

04/10/2022

Proficiency in fast rescue boats

A-VI / 2-2

Advanced fire fighting

A-VI / 3

34638/17/EG.

08/10/2017

EGYPT

04/10/2022

Medical & first aid

A-VI / 4-1

35298/17/EG.

12/10/2017

EGYPT

11/10/2022

Medical care

A-VI / 4-2

Radar & ARPA simulator training- management level

A-II / 1-2

16755/18/EG.

29/05/2018

EGYPT

XXXXXXXXXX

Electronic chart display and information system course (ECDIS)

A-II / 1

Model 1.27

23145/18/EG.

02/08/2018

EGYPT

XXXXXXXXXX

GMDSS & endorsement

A-IV / 2

11463/18/EG.

12/04/2018

EGYPT

04/04/2023

Ship Security Officers course (SSO)

A-VI / 5

Proficiency in security awareness (PSA)

A-VI / 6-1

37814/17/EG.

31/10/2017

EGYPT

29/10/2022

Proficiency in designated security duties (PDSD)

A-VI / 6-2

Bridge team management

A-II / 2

Bridge resources management (BRM)

B-VIII / 2

51208/18/EG.

29/07/2018

EGYPT

XXXXXXXXXX

ISM code

A.1441 (18)

Engine room resources management (ERM)

A-III/1, A-III/2,

A-III / 3,

Helm (leadership and management skills)

A-II / 2, A-III / 2

Tankers familiarization

A-V / 1 (1, 2)

1229/18/EG.

09/07/2018

EGYPT

01/07/2023

Basic Tanker operations (Oil Tanker & Chemical Tanker)

A-V / 1-1-1

Advanced Oil Tanker operations

A-V / 1-1-2

Advanced Chemical Tanker operations

A-V / 1-1-3

Basic Tanker operations (LPG Tanker)

A-V / 1-2-1

Advanced Tanker operations (LPG Tanker)

A-V / 1-2-2

Crowd Management for passenger ship

A–V / 2-1

Crisis Management and Human Behavior on Passenger Ships

A-V / 2-2

Basic Training for IGF code

A-V / 3-1

Advanced Training for IGF code

A-V / 3-2

Basic Training for ships operating in polar waters

A-V / 4-1

Advanced Training for ships operating in polar waters

A-V / 4-2

Food Handling and Hygiene

Medical / health certificate

MLC 2006

197150

30/08/2018

EGYPT

29/08/2020

Drug and alcohol test

Yellow fever

09/01/2012

EGYPT

09/01/2022

SECTION 6- OTHERCERTIFICATION / COURSES YOU MAY HAVE

Name of Course / Certificate

Approvals

Certificate number

Date of issue

Place of issue

Date of expiry

Quality Management

Environmental Management

Energy Management

BOSIET / FOET

HUET

CA-EBS

Hydrogen Sulphide (H2S)

HLO / HLA

Helicopter Team Member

Rigging and slinging

Fast Recue Craft Coxswain

Boatman Certificate

Crane Maintenance

Offshore medicals (UK, Norway or Netherlands)

Re-breather training

Generic ECDIS

ECDIS Furuno

JRC ECDIS

SIMRAD MARIS ECDIS 900

KONGSBERG K BRIDGE-ECDIS

TRASAS NAVISAILOR ECDIS

ADDITIONAL CERTIFICATION / COURSES YOU MAY WISH TO MENTION TO SUPPORT YOUR APPLICATION

Name of Course / Certificate

STCW Code / Approvals

Certificate number

Date of issue

Place of issue

Date of expiry

Marlin’s English test score (Percentage %):

PMS maintenance system- are you familiar with its use(Yes / No):

If yes- please specify the PMS types:

SECTION 7- DYNAMIC POSITIONING (DP) CERTIFICATION

Name of Course / Certificate

Approvals

Certificate number

Date of issue

Place of issue

Date of expiry / unlimited

DP maintenance course

High voltage course

DP induction course

DP simulator course

DPO certificate (details of old certificate- before renewal)

DPO certificate (details of new certificate- after renewal)

DP log book details

NUMBER OFHOURS / DAYS DONE WITH VARIOUSDYNAMIC POSITIONING SYSTEMS

System details

Approximate number of hours / days (please clarify which)

SDPO

DPO

Senior ETO / Senior Engineer

Junior ETO / Junior Engineer

APPROXIMATE TOTAL DP HOURS ON VARIOUS VESSELS / OPERATIONS

Sat diving

Cable laying

Air diving

Survey

ROV

Pipe laying

Well stimulation / intervention / activation

Drill ship / Semi-submersible

AHTS

PSV

FPSO

Shuttle Tanker

Construction

Rock dumping / Mattressing

Coring

Trenching

Heavy lift

Accommodation / Gangway

SECTION 8-MEDICAL HISTORY

Particulars

Yes / No

1. Have you ever had to sign off/ repatriated from a ship due a medical reason and been hospitalised?

no

2. Have you undergone any medical operations in the past?

no

3. Have you had to consult a doctor during the past 12 months for an illness / accident?

no

4. Do you have any medical condition that may affect your work?

no

5. Do you feel healthy and fit to perform the duties of your designated position/occupation?

yes

6. Are you allergic to any medications?

no

If you have answeredYes to any of the above then specify below

5-yes Yes, I enjoy good health to perform all the functions of my job

7. Are you taking any prescribed or non-prescribed medications at present?

If yes, please list these medications, their dosage and their purpose / reason for taking:

no

Prescribed Medications (please name)

Dosage

Purpose / reason for taking

Non-prescribed Medications (please name)

Dosage

Purpose / reason for taking

SECTION 9- GENERAL

Particulars

Yes / No

1. Have you ever been involved in a maritime accident, i.e. grounding, fire, explosion, collision

no

2. Have you ever been rejected by Aramco / Shell or any other Charterer?

no

3. Have you ever been the subject of a court of enquiry or involved in a maritime accident?

no

4. Have you ever had a professional license suspended or revoked?

no

5. Have you ever been convicted of any criminal offence?

no

6. Have you ever been dismissed due to any reason?

no

If you have answeredYes to any of the above then specify below

SECTION 10- LAST TWO EMPLOYMENT CONTACT DETAILS

Name of company:

GLOBAL OVERSEAS MARITIME LTD.

Name of contact person:

MOHAMED ABD EL HAI

Company address:

PORT SAID – EGYPT

Contact number:

+201*********

Email address:

adbaoc@r.postjobfree.com

Name of company:

Name of contact person:

Company address:

Contact number:

+

Email address:

SECTION 11A- SEA SERVICE RECORD

PLEASE MENTION FULL RECORD OF SEA SERVICE AS PER SEAMAN BOOK STARTING FROM LAST VESSEL FIRST

Vessel

Company

Area of operation

Type of vessel (type of operation in case of DP vessels)

DWT or GRT

(please clarify)

Type of engines / DP System /

Crane make and model

BHP / SWL of Crane

Rank

Sign on date

(dd/mm/yyyy)

Sign off date

(dd/mm/yyyy)

For office use only

Number of days

Number of running days

Osama

Yahya shipping co.

The Mediterranean Sea

General cargo

5000

WB

6000/25 tons

CADET

27/09/2012

16/04/2013

ENERGY 3

GULF OVERSEAS CO.

Arabian Gulf and Indian Ocean

General cargo

8000

SULZER

6000/33 TONS

CADET

13/06/2013

17/01/2014

AT30

TABALO SHIPPING CO.

The Mediterranean Sea

BULK CARRIER

33000

WERTSELA

8000/40 TONS

3rd MATE

15/03/2014

22/01/2015

KOTA LAMBANG

PIL CO.

East Asia and the Indian Ocean

CONTINER VESSEL

39906

B/W

8000

3rd MATE

02/02/2016

21/08/2016

KUWAIT ANA

SILVER STAR SHIPPING MANAGEMENT

Arabian Gulf and Indian Ocean

BULK CARRIER

24111

B/W

8000

2ND MATE

23/12/2016

13/07/2017

MED PRODIGY

GLOBAL OVERSEAS MARITIME LTD.

The Mediterranean Sea

CONTINER VESSEL

6393

WERTSELA

6000/30 TONS

2ND MATE

20/12/2018

30/06/2019

NOTE for Column 6, please mention:

For Engineers = type of engines; For DPOs = DP System; For Crane operators = Crane make and model

NOTE for Column 7, please mention:

For Officers / Engineers = BHP; For Crane operators = SWL

SECTION 11B- AHTS / AHT EXPERIENCE IF ANY (ONLY FOR DECK OFFICERS)

NUMBER OF DAYS WITH VARIOUS OPERATIONS

Vessel name

(please put last vessel first, voyage by voyage)

Description of operations (please specify number of days)

Towing

Anchor handling

Rig move

4-point mooring

Deep water anchor handling experience- state to what depth in metres:

SECTION 12- ADDITIONAL INFORMATION

VESSEL TYPE YOU ARE INTERESTED IN (PLEASE LIST IN ORDER OF PRIORITY)

1

BULK CARRIER

2

CONTINER SHIP

3

GENERAL CARGO

4

RORO VESSEL

5

OFFSHORE VESSEL

LANGUAGES KNOWN- RATE FROM 1 (POOR) TO 5 (FLUENT)

Language

Spoken

Written

Understood

1

ENGLISH

YES

YES

YES

2

ARABIC

YES

YES

YES

3

FRENCH

Acceptable

NO

Acceptable

ANY OTHER INFORMATION YOU WISH TO ADD IN SUPPORT OF YOUR APPLICATION

DATA PROTECTION NOTIFICATION:

Here at Ryan (hereafter referred to as Crew Managers), we take your privacy seriously and treat your personal information with the utmost care. The information you provide will be stored on our secure database and used in cases of:

Searching assignment and assignment management.

Where necessary to comply with laws, regulations or contracts applicable to any of the employing companies or their businesses and in accordance with any limitation period.

Where necessary to protect your vital interests

Your personal information will never be sold to third parties or for marketing.

If at any point you believe the information we possess on you is incorrect you can request to see this information and request to have it corrected or deleted. If you have any query or complaint, please address any correspondence to our Data Protection Officer on email: adbaoc@r.postjobfree.com

SEAFARER DECLARATION STATEMENT:

I hereby declare that the above facts and information I have provided are true and accurate. I acknowledge and accept that (i) the Owners/Managers of any vessel to which my application and/or assignment is organised and (ii) the Crew Managers and associated companies may each process my personal information (including any of my personal information provided at a later date) for the purposes of searching assignment, managing assignment, compliance with laws, regulations and contracts applicable to any of the employing companies or their businesses and in accordance with any limitation periods and where necessary to protect my vital interests.

I understand that my personal data will be stored in the Crew Managers’ secure database and otherwise processed for the above purposes, in connection with, and during the period of my current period of assignment and thereafter for such further period (if any) as is necessary to fulfil the abovementioned purposes. I also understand that the abovementioned processing activities may involve the transfer of my personal information from the Crew Managers to any of the other companies. This may involve the transfer of my personal information to jurisdictions whose data protection laws do not provide equivalent protection to my home country subject to the companies taking appropriate measures to ensure that my personal data is kept secure at all times. To the extent that my personal information includes sensitive personal information, I consent to the Crew Managers processing such sensitive personal information as stated above.

Please select appropriate box, print name, and date in acceptance of the above declaration:

Accepted:

Yes

No

YES ACCEPTED

Seafarer name (full name):

MOUSTAFA THARWAT MOUSTAFA ZAYEDA

Date (dd/mm/yyyy):

16/10/2019



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