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    Personal Details/Officer'S Application Form: Boiler Suit Size

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    rowshanazmeri2

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    © All Rights Reserved
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    Personal Details/Officer'S Application Form: Boiler Suit Size

    Uploaded by

    rowshanazmeri2
    7 views2 pages

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    7 views2 pages

    Personal Details/Officer'S Application Form: Boiler Suit Size

    Uploaded by

    rowshanazmeri2

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    of 2

    PERSONAL DETAILS/OFFICER'S APPLICATION FORM

    APPLIED FOR technical superendent DATE 20.9.2015


    FIRST NAME MIDDLE NAME LAST/SUR NAME
    MOHAMMED IMRUL HAQUE
    DATE OF BIRTH PLACE OF BIRTH NATIONALITY PHOTO
    15.05.1974 dinajpur BANGLADESHI
    B-8,Equity lavinia,30,mehedibagh,chittagong
    ADDRESS

    E-MAIL mihm_bd@yahoo.com PHONE 31619086 MOBILE : 01921596784


    HEIGHT 176 cm BOILER SUIT SIZE BLOOD GROUP 0 nagative MARITAL STATUS married
    WEIGHT 78 kg S. SHOE SIZE COLOR OF EYE black AVAILABILY 20.01.2014
    NEXT OF KIN/NAME Mrs. Rowshan jahan ajmeri RELATION wife DOB 24.07.19 MOBILE/TEL 31619086
    EMERGENCY CONTACT same above RELATION DOB MOBILE/TEL
    FULL ADDRESS B-8,Equity lavinia,30,mehedibagh,chittagong
    BANK A/C DETAILS account no- 18-1145494-01,standard chartared bank,main branch,agrabad,chittagong
    ACADEMIC QUALIFICATION
    TRAINING INST. NAME FROM TO CERTIFICATE OBTAINED GRADE / MARKS YEAR
    MARINE ACADEMY.CHITTAGONG 1993 1995 ENGINEERING PHASE-1 CERTIFICATE 1995

    RECORD OF SEA SERVICE


    SERVED(MM/DD/YY) DURATION
    Reason Crew
    OWNER / MANAGER SHIP'S NAME RANK GRT VESSEL ENGINE BHP for Sign- FLAG
    FROM TO MONTH/D% Nationality
    TYPE off
    Naaf marine services M.v pangaon suc2.07.2013 30.11.2013 4m7d 2nd engr 2195 container Zibo 584 EOC Bangladeshi panama
    Titan ocean m.t titan peace 01.09.2012 11.04.2013 7 m 10 d 3rd engr 6190 chemical SXD-MAN 4437 EOC mixed singapore

    Marine Trust ce-shilla 24.05.2012 27.07.2012 2m3d 3rd engr 59289 crude oil HUNDAI B & W 15300 Management change mixed monorovia

    v.ships m.t ratih 18.07.2011 06.02.2012 6 m 18 d 2/A/E 5979 chemical Hitachi B & W 5280 EOC mixed singapore

    v.ships/luna ship M.t brixham 24.05.2010 02.10.2010 4m8d 3rd engr 4568 product Hundai himsen 3549 Management change mixed panama
    PCL m.t Sulawesi pa 10.06.2009 29.12.2009 6 m 19 d 3rd engr 11243 chemical Man B & W 6756 EOC mixed singapore

    AET M.T EAGLE VENI 13.02.2009 11.04.2009 1 m28 d 3rd engr 160046 VLCC HUNDAI B & W 27160 Family reason mixed port klang

    UASC M.T AL farabi 24.05.2008 22.12.2008 6 28 d 3rd engr 26464 chemical mitsui b & w 12575 EOC mixed dammam
    OCEAN TANKER M.T OCEAN STA 20.06.2007 15.01.2008 6 m 25 d 3rd engr 52853 crude oil HUNDAI B & W 20500 EOC mixed tuvalu
    BSC m.v banglar shi 30.12.2005 04.07.2006 6m4d 3rd engr 9927 container sulzer 5661 EOC bangladeshi chittagong

    BSC M.T BANGLAR S 24.07.2005 29.12.2005 5m5d 3rd engr 8672 CRude oil MAN B & W 4504 EOC bangladeshi chittagong

    BSC m.v banglar shi 21.04.2005 23.07.2006 3m2d 3rd engr 9927 container sulzer 5661 EOC bangladeshi chittagong

    DOCUMENT DETAILS
    DOCUMENT NUMBER DATE OF ISSUE DATE OF EXPIRY PLACE OF ISSUE ISSUING AUTHORITY/REMARKS
    PASSPORT AD 4244241 05.08.2012 04.08.2017 CHITTAGONG BANGLADESH GOV.
    SEAMAN BOOK C/O/3305 06.02.2008 05.02.2018 CHITTAGONG SHIPPING OFFICE,CHITTAGONG
    COC: Class (Deck/Motor) class 3 engr BD 2 11.12.2002 10.12.2017 DHAKA DEPARTMENT OF SHIPPING,DHAKA
    GMDSS (N/A for Engineer)
    Seafarer's ID Card 50000176 16.02.2010 15.02.2015 DHAKA DEPARTMENT OF SHIPPING,DHAKA
    VISA US- C1/D
    US- B1/B2
    SINGAPORE

    MANDATORY COURSES AS PER STCW/SOLAS/ISPS


    CERTIFICATE NAME CERT. NO. DATE OF ISSUE PLACE OF ISSUE ISSUING AUTHORITY VALIDITY
    Elementary First Aid
    Medical Care/Medical First Aid 1484 22.10.1998 CHITTAGONG MARINE ACADEMY,CHITTAG 31.12.2016
    PSSR PSSR/0237/30.11.2002 DHAKA IIMT 31.12.2016
    Fire Prevention and Fire Fighting
    Advance Fire Fighting 2512 31.03.1999 CHITTAGONG MARINE ACADEMY,CHITTAG 31.12.2016
    PSCRB PSCRB/023 19.11.2002 DHAKA IIMT 31.12.2016
    Radar Observers Course (ROC)
    Automatic Radar Plotting Aids (ARPA)
    Bridge Team Management (BTM)
    Security training for seafarer with designated BDSTSDSD- 09.01.2014 DHAKA DEPARTMENT OF SHIPPING,D 08.01.2019
    Security awarness training BDSAT-261 09.01.2014 DHAKA DEPARTMENT OF SHIPPING,D 08.01.2019
    Elect Chart display and info (ECDIS))
    Tanker Familiarization (Oil, Chem & Gas) TF/CTG/07021.03.2007 DHAKA IIMT 31.12.2016
    Adv. Oil tanker Program. STTP-O/10212.12.2010 DHAKA IIMT 11.12.2015
    Adv. Chem tank Program. BDACT-508 22.04.2013 DHAKA DEPARTMENT OF SHIPPING,D 31.12.2016
    National License (COC N)
    Flag State License (COC F)
    DCE (Oil, Chem & Gas) BD BOC E0 07.05.2012 DHAKA DEPARTMENT OF SHIPPING,D 31.12.2016

    ADDITIONAL COURSES
    Engine room resource management PMTRI/ERM08.12.2010 NAVI,MUMBAI PMTRI,MUMBAI,INDIA 07.12.2015
    Planned Maintenance System (PMS)
    Risk Assessment and Management (RAM)
    Energy Conservation
    Accident Investigation
    Environmental Awareness
    Bridge Resource Management (BRM)
    Bridge Engine Resource MGT (BERM)
    Ship Board Safety Officer (SBSO)
    OPA 90-VRP & VGP (OPA 90)
    H Press Hydrs/Framo (HPS)
    Vapour Emission Control System( VEC)
    Officer of Watch (See note 08)
    PSC and Vetting Inspections(INSPXN)
    Life Boat on Load Release Gear (LBRG)

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