Seaman Vessel

APPLICATION FORM

Position

Position applied for ORDINARY SEAMAN

Lowest rank

acceptable

ORDINARY SEAMAN

Preferred vessel type Bulk Carrier

Readiness date 25/Apr/2022

Personal Details

Last name Sharma First name Raju

Middle name Gender M

Date of birth 20/Apr/2001 Nationality Indian

Place of birth Gurgoan

Country of Residence India City of Residence Gurgoan Phone 704-***-**** Mobile 938-***-****

Zip code E-mail *********@*****.***

Address

Identity Documents

Passport number U1479060 Seaman book

number

MUM444097

Passport issue date 04/Dec/2019 Seaman book issue

date

03/Nov/2021

Passport expiry date 03/Dec/2029 Seaman book expiry date

11/Nov/2031

Passport issue

country

India Seaman book issue

country

India

Education

No record found

Certificates

No record found

Licences

No record found

Visas

No record found

Vaccinations

No record found

Special Skills

No record found

Sea Services

No record found

Pre-Employment Checks

No record found

Experience

Declaration

I hereby confirm that (i) all the information given above is true, correct and complete to the best of my knowledge and belief and (ii) I have not withheld any information that could have, in any way, affected my application. Any false or incomplete declaration I made herein may constitute ground for disqualification and nonacceptance by the Company and could, in addition, result in applicable penalties in accordance to existing laws and regulations governing the recruitment and employment of overseas seafarers. RPSL - MUM – 165 I Issue date: 12.03.2020 I Valid till: 12.03.2025 Signature: Date:

ORDINARY SEAMAN Sharma, Raju

21/Apr/2022

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