APPLICATION FORM

1 Position 3/0 ID/PD No. (For Office Use Only)

_______________________
Position applied for:
Are you willing to accept any other positions? If YES, which positions would you consider? YES/NO

Are you responding to a media advertisement? If YES, please state which publication YES/NO

From what date will you be available?

2 Personal details

Name: (Surname) PHYO MAUNG MUANG

(First Names) PHYO
(Middle Name) MAUNG
Date/Place of Birth: 08-05-1986 Nationality: MYANMAR
Permanent address: NO (40) NAY THU YEIN STREET,SAYAR SAN (SOUTH)WARD,BAHAM, TOWOSHIP,YANGON
Pin Code:
E-Mail: pmn.719@gmail.com Tel No. : 09420003058 Mobile 09420003058
Local address: NO (40) NAY THU YEIN STREET,SAYAR SAN (SOUTH)WARD,BAHAM, TOWOSHIP,YANGON
Pin Code:
E-Mail: pmn.719@gmail.com Tel No. 09420003058 Mobile 09420003058

3a Educational Background I HAVE FINISHED FROM DANGON UNIVERSITY BY MATHEMATICS (BSC)

Qualification School / College From To Percentage/ Grade
GRADUATE DANGON UNIVERSITY 2002/03 2005/06 MATHEMATICS
UNIVERSITY

3b Technical Background
Degree/ Diploma Institute/ College From To Percentage / Grade

4 Identity documents

DOCUMENT COUNTRY NUMBER DATE OF ISSUE PLACE OF ISSUE DATE OF EXPIRY

Passport: Myanmar ME 457550 02 AUG 2019 YANGON 01 AUG 2024
Seaman Book: National 73608 07 MAY 2019 YANGON 06 MAY 2029
Panamanian
Liberian
Others
Do you hold a US Visa ‘C1/D’? YES/NO NO Issue Date: Expiry Date:
Do you hold a US Visa ‘B1/B2’? YES/NO NO Issue Date: Expiry Date:
Have you been rejected for any visa applied for? YES/NO
If YES, please state the country and reasons
INDOS No: (only for Indians) YELLOW FEWER V/T 2013 APR 25
MUI NO : V/T

5 Family Details: (If Unmarried kindly give details of Father / Mother)

NAME PO PASSPORT PLACE OF DATE OF DATE OF
Relation DOB ECNR
B NO. ISSUE ISSUE EXPIRY

6 Certificates (Highest certificate of competency held)

MSCCS-MANN-8.5-01-01 01 MAY 2017 REV-0

 Grade/Class Date of Passing Certificate
Of COC Issuing Country Date Issued Place Issued Valid Until
Exam No.
Country3
CLASS MYANMAR 2019-04-12 3DK008708 2019-JUL-12 YANGON 2024- JUL-11

7 Certificates Of Competency issued by other countries (Issued by countries other than in Section 6)

Issuing Country Certificate No. Date Issued Place Issued Valid Until
Panama
Others KOREA MARITIME KOREA 2024-JUL-11
LAW
8 Details of Courses
Courses Certificate No. Issued By Date Issued Date Of Expiry
FPFF / AFF 3DK008708 YANGON 2019-JUL-12 24- JUL-11
EFA / MFA / MEDICARE 3DK008708 YANGON 2019-JUL-12 24- JUL-11
PSCRB 3DK008708 YANGON 2019-JUL-12 24- JUL-11
PST
PSSR – Personal Safety & Social Responsibilities
SSO – Ship Security Officers Course / STSDSD 3DK008708 YANGON 2019-JUL-12 24- JUL-11
ISPS Course
ROSC – Radar OBS Simulator 3DK008708 YANGON 2019-JUL-12 24- JUL-11
ARPA – Automatic Radar Plotting Aid 3DK008708 YANGON 2019-JUL-12 24- JUL-11
RANSCO – Radar, Arpa & Navigation Simulator
BTM
SMS / SHS / ERS
ECDIS 3DK008708 YANGON 2019-JUL-12 24- JUL-11
Bridge / Engine Resources Management (BRM / ERM) 3DK008708 YANGON 2019-JUL-12 24- JUL-11
Ship Master Command and Control Course
GMDSS + endorsement 3DK008708 YANGON 2019-JUL-12 24- JUL-11
RUTC – Refresher & Up gradation Course
Container Operations Familiarization
Electrical Familiarization for Marine Engineers
Electronics for Marine Engineers
Instrumentation & Shipboard Control Systems
Automation and Controls
Container Refrigeration
Hydraulics for Engineers (Basic / Advance)
Hazmat (In compliance with STCW-95 Section-B -V/b & V/c & CFR – 49)
CFR-49 and Pneumatics Workshop
Hydraulics
Watch Keeping Certificate Ratings (Deck/Engine)
Applied Electronics (AELC)
Practical Marine Electrical Workshop
Engine Equipment Maintenance Workshop
Basic Electrical and Fluid Technology
Reefer Container and Maintenance Course
MEPC
Operational competence enhancement course for deck
officers
Safety, Environment Compliance & Pollution Prevention
Training for Crew
Vessel Resource Management (VRM)
Electro Technical Officer/ Rating Certificate
COP

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 9 Record of previous service
9 (Please give a full record starting with the last vessel on which you served)

TYPE OF ENGINES
VESSEL D.W.T/ CONTS VSL SIGN ON SIGN OFF DURATION REASONS FOR
COMPANY VESSEL NAME (Please give full B.H.P RANK
TYPE GRT TEU’S AGE dd/mm/yy dd/mm/yy yy/mm/dd S/OFF
dtls)
Has magnament Heung-A young container 9599 1113 7ago 8280 kw 2/0 2022- 2022- 3M 7D COMPLETED
APR-30 AUG-07 CONTRACT
Has magnament Heung-A young container 9599 1113 7ago 8280 kw 3/0 2021- 2022- 5M 10D COMPLETED
NOV-20 APR-30 CONTRACT
Keumyang mv- keumyang G/C 4713 12 HANSHI FOUR 3600HP 2/0 2021- 2021- 1M 15D COMPLETED
shipping post ago STROKE FEB- APR-12 CONTRACT
27TH
Keumyang mv- keumyang G/C 4713 12 HANSHI FOUR 3600HP 3/0 2020- 2021- 1Y 26D COMPLETED
shipping post ago STROKE JAN- FEB-26 CONTRACT
31ST
HYUNDAI mv- Hyundai Full 52581 4700 8 62240BHP O/S 2016- 2017- 8M COMPLETED
Marchant voyager container ago OCT-24 JUN-10 CONTRACT

HYUNDAI mv- Hyundai bulk 68093 22 11523 kw o/s 2016- 2016- 8M COMPLETED
Marchant spirit ago JAN-26 SEP-18 CONTRACT

DONGJIN mv- Dongjin G/C 3847 17 HANSHI FOUR 30000HP A/B 2014- 2015- 11M 2D COMPLETED
SHIPPPING nagoya ago STROKE JUNE-27 MAY- CONTRACT
2015
Keumyang mv- keumyang G/C 4713 6y HANSHI FOUR 3600HP O/S 2013- 2014- 1Y 2 M COMPLETED
shipping prime ago STROKE MAR-29 MAY-30 CONTRACT

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10 For Engineers (Please provide details)

Generators

Purifiers and Boilers

Type of Cranes / No of Reefer

Containers

11 Sailing Experience: (Please advise PRESENT RANK EXPERIENCE on each type of vessel)

Container PCC Reefer Multi Purpose Others

LAST SALARY DRAWN (PLEASE MENTION CURRENCY)

12 Medical history
Have you ever signed off a ship due to medical reasons? YES/NO NO
Have you undergone any operation in the past? YES/NO NO
Have you consulted a doctor during the last 12 months for an illness/accident? YES/NO NO
Do you have any health or disability problems now? YES/NO NO

(If the answer is YES to any of the above, please give full details and attach a separate page if necessary)

13 General

Have you ever been the subject of a court of enquiry or involved in a maritime accident? YES/NO NO
Have you ever had a professional license suspended or revoked? YES/NO NO

(If YES, please give full details and attach a separate page if necessary)

14 References (Please give the name and address of your current or immediate past employer)

Name of company 1. HAS MANAGAMENT 2.

Name of person to contact
Address

 No.

15 Review

If immediate employment is not available do you wish to be considered for future vacancies? YES/ NO YES
If YES, please give any alternative contact details not shown in Section 2

16 Declaration

I hereby declare that the above particulars are true and authorise you to contact the referees listed above.
Date:

Signature
17 BOILER SUIT SIZE: L SIZE SAFETY SHOE SIZE: 260MM

MSCCS-MANN-8.5-01-01 01 MAY 2017 REV-0