*. PERSONAL DETAILS

Surname :BHARDWAJ First Name: BIPUL Middle Name:

Nationality :INDIAN Date of Birth :13/01/1998 Place of Birth :SAMASTIPUR Weight (kg) :68KG Height (cm) :172 BMI :

Post Applied for :DECK CADET

Permanent Address : Present Address :

VILL & PO-DHARMAGATPUR BATHUA VILL & PO-DHARMAGATPUR BATHUA PIN Code:848115 Nearest Airport: DARBANGHA PIN Code:848115 Nearest Airport: DARBANGHA Tel No / Mobile No: 992-***-**** Tel No / Mobile No: 756-***-**** Email ID: admw35@r.postjobfree.com

2. PASSPORT DETAILS

Passport No.

Date of

Issue

Place of Issue Date of Exp. ECNR Blank Pages

P3159075 18/01/2017 PATNA 17/01/2027 32

3. CONTINUOUS DISCHARGE CERTIFICATE / INDOS

Seaman’s

Book (CDC)

Number Date of Issue Place of Issue Expiry Date Remark Indian MUM350073 14/12/2018 MUMBAI 13/12/2028

INDOS 15NL0811 28/08/2015 INDIA

4. FAMILY INFORMATION

Full Name of Next of Kin : BIRENDRA SHARMA Relationship :FATHER Address of Next of Kin: VILL & PO-DHARMAGATPUR BATHUA PIN Code:848115

Tel No. :808-***-****

Family Data Name Occupation Contact Number/e-mail ID Father BIRENDRA SHARMA FARMER 808-***-****

Mother CHITRA REKHA KUMARI RETIRED TEACHER 993******* Brother/Sister SHIKHA BHARTI STUDENT 808-***-****

Any Relatives in Marine Field –NO

Photograph

5. ACADEMIC QUALIFICATION

QUALIFICATION

YEAR OF

PASSING

PERCENTAGE

PCM

PERCENTAGE

BOARD / UNIVERSITY

B.Sc. NAUTICAL

2020 72.6

MIT ADT UNIVERSITY

H.S.C.

2015 74 83 BIHAR BOARD

S.S.C.

2013 79 7.9CGPA CBSE

6. STCW AND OTHER COURSES

Details of Courses &

Certificates

Dt. Of Issue Dt. Of Expiry Pl. of Issue Issued by

Advanced / Basic Fire

Fighting

21/06/2017

20/06/2022

KOLKATA MMA

Proficiency in Survival Craft /

Rescue Boat / PST / PSC RB

Up gradation

17/06/2017

16/06/2022

KOLKATA MMA

STSDSD 23/06/2017 22/06/2022 KOLKATA MMA

Elementary / Medical First Aid

/ Medicare

16/03/2021

NA

KOLKATA SEMSEA

PSSR 10/02/2021 NA KOLKATA SENSEA

Basic OIL & CHEMICAL 18/05/2021 NA KOLKATA SENSEA

7. DC For OIL & CHEMICAL - AVAILABLE

8. HOBBBIES AND INTRESTS- VISITING NEW PLACES AND TRAVELLING 9. OTHER CERTIFICATES

Sr. No.

Details of the Certificates

01 ALL BIHAR SUB JUNIOR CRICKET TOURNAMENT

02 INTER-SCHOOL CRICKET

03 SOFT SKILL TRAINING

04 SOFT SKILL DEVELOPMENT WORKSHOP

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is true and correct to the best of my knowledge and belief; further, that no Certificate issued to me has ever been Revoked or Suspended.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 20 /05 /2021 Name- BIPUL BHARDWAJ

Signature

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