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  * required fields
   
       Position Applied: *
  Alternate Position: *
   
  PERSONAL DETAILS
  Last Name: * Date of Birth: *
  Middle Name: Place of Birth: *
  First Name: * Sex:
   
  Mailing address: *
  Zip Code: City: *
  State:
  E-mail address : *
  Landline number:
    Cell phone number:
 
EDUCATIONAL ATTAINMENT
Name of last school attended: *  
Degree/Certificate obtained: *  
Completion date: *  
 
 
SHIPBOARD EMPLOYMENT DOCUMENTS
       
Passport Place issued: Number: Validity:
Seaman's book Place issued: Number: Validity:
Yellow Fever Place issued: Number: Validity:
US Visa Place issued: Number: Validity:
GOC Certificate Place issued: Number: Validity:
PRC endorsement Rank: Number: Validity:
TESDA COC Rank: Number: Validity:
       
       
TRAINING CERTIFICATES
Date Issue
Name of Training Center
NAC COP Certificate no.
Basic Safety Course (BSC)
14-
Personal Safety and Social Responsibilities
N/A
Proficiency In Survival Craft and Rescue Boat
15-
Medical Emergency-First Aid (MEFA)
18-
Specialized Training in Oil Tanker Operation
9-
Specialized in Chemical Tanker Operation
10-
Specialized Training in Liq. Gas Tanker
11-
General Tanker Familiarization (GTF)
8-
Shore-Based Fire Fighting (SBFF)
N/A
Inert Gas System / Crude Oil Washing
N/A
Engine / Deck / Navigational Watch Keeping
N/A
Ship Simulator And Bridge Teamwork
N/A
 
 
 SHIPBOARD EXPERIENCE
 
Latest Contract
Two
contracts ago
Three
contracts ago
Four
contracts ago
Five
contracts ago
Name of vessel
Flag
Year Built
GRT
Trade route
Main Engine
Type of Vessel
Rank
Salary (All in)
US$
US$
US$
US$
US$
Sign on (DD/MM/YY)
Sign off (DD/MM/YY)
Reason for signing off
Nationality of Master
Nationality of C/Eng
Name of Principal
Nationality of Principal
Name of Philippine Manning Agency
 
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