* ****** ***** ******* **

crewdata.com

SEAFARER'S APPLICATION FORM http://crewdata.com

Position: ELECTRICIAN

or ELECTRICAL ENGINEER

Readiness: 09.05.2018

Citizenship: Egypt

Last name: Hassan Marital status single

First name: Basem Children:

Middle name: Samy Nationality: Egyptian

Birth date: 15.09.1992 Birth place: Egypt

Home address: Alexandria, Smoha, Egypt Phone mobile: 002(010)29087735 Phone home: 004(07)31952771

Email: basm201091@gmail.c

om

English level: Fluently Marlins Test: 91

Salary Minimum: 1900 Expected: 6000 Last: $/month

Education

Educational institution Speciality Faculty Place Number From Till Hurghada Secondary

Industrial

Electrical fixtures and

equipment

High

School

hurghada/EGY 107 20.09.2009 20.09.2012

Passports, Licenses & Certificates

Title Class Number Place of issue Issued Valid

Passports & Visas

Seaman's book 204541 alexandria, EGY 14.05.2017 13.05.2022 Civil passport 0201492 alexandria, EGY 05.12.2015 01.01.2100 Travel passport A17133640 alexandria, EGY 27.12.2015 26.12.2022 Certificates & Licenses

Advanced Fire Fighting (VI/3) 24088.17.EG alexandria, EGY 11.06.2017 06.07.2022 Medical First Aid (VI/4.1) 24088.17.EG alexandria, EGY 11.06.2017 06.07.2022 Personal Survival Techniques (A-VI/I-l) 24088.17.EG alexandria, EGY 11.06.2017 06.07.2022 deletePersonal Safety and Social Responsibilities (A- V1/1-4)

24088.17.EG alexandria, EGY 11.06.2017 06.07.2022

Proficincy of security awareness training for seafarers with designated security duties

38872/18/EG alexandria, EGY 16.12.2018 16.12.2023

Medical Certificates

Yellow Fever Vaccination alexandria, EGY 03.10.2017 03.10.2037 Medical Fitness Certificate alexandria, EGY 03.10.2017 02.10.2019 Sea-going experience

Vessel’s

name

Flag Type Engine

Rank

From Shipowner

Year DWT HP Till Crew Agency

1 Skippers y

SLE Bulk Carrier Sulzer

Electrician

27.05.2019

Shippers ship . Trade .

LTD

198*-*****-**** 27.11.2019 Merjo marine

2 Maridive 519

BLZ

Offshore Support

Vessel

Caterpillar

Electrician

25.03.2019 Maridive group

200*-****-**** 24.05.2019 Merjo marine

2 Hassan Basem created by

crewdata.com

3 Maridive m

BLZ AHTS Niigata

Electrician

09.03.2019 Maridive group

201*-****-**** 09.04.2019 Merjo marine

4

Maridive mwm

601

BLZ AHTS Niigata

Electrician

28.09.2018 Maridive group

201*-****-**** 09.02.2019 Merjo marine

5 Sealady

SLE AHTS Caterpillar

Electrician

11.07.2018 Ships and bote

200*-****-**** 21.08.2018 Merjo marine

6 Mv setia lestari

PAN AHTS Caterpillar

Electrician

12.10.2017 Marine core & charter

200*-****-**** 12.04.2018

Fujairah national

shipping

7 Ansar 18

SAU AHTS Caterpillar

Electrician

08.06.2017 Merjo marine

200*-****-**** 20.08.2017 Merjo marine

Crewing Agencies or Marine Companies

Crew Agency City Country Contact Person Phone

Merjo marine alexandria Egypt El masri Adel 002(012)01407755 Fujairah national shipping Dubai United Arab Emirates Soltan Ahmed 971(56)6606671 General Physical State

Height (cm) Weight (kg) Shoes Clothes Hair color Eye color 178 72 42 M brown light brown

Date applied: 13.01.2020 Signature:

Contact this candidate