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    Lotus Shipping Company Limited Procedure: LP 06: OFF - CREW-03

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    This document contains the employment form for deck cadet Beka Kirkitadze of Georgia. It lists his personal details, qualifications including certificates of competency, medical certificates, and sea service experience aboard the tanker MT Cadet. His qualifications and certificates were verified by the manning agent and crew manager as authentic and his background check was found satisfactory. The candidate was approved for employment by the Lotus Shipping Company.

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    Lotus Shipping Company Limited Procedure: LP 06: OFF - CREW-03

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    Анжела Ованесян
    57 views5 pages
    This document contains the employment form for deck cadet Beka Kirkitadze of Georgia. It lists his personal details, qualifications including certificates of competency, medical certificates, and sea service experience aboard the tanker MT Cadet. His qualifications and certificates were verified by the manning agent and crew manager as authentic and his background check was found satisfactory. The candidate was approved for employment by the Lotus Shipping Company.

    Original Title

    KIRKITADZE BEKA D-C

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    This document contains the employment form for deck cadet Beka Kirkitadze of Georgia. It lists his personal details, qualifications including certificates of competency, medical certificates, and sea service experience aboard the tanker MT Cadet. His qualifications and certificates were verified by the manning agent and crew manager as authentic and his background check was found satisfactory. The candidate was approved for employment by the Lotus Shipping Company.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    57 views5 pages

    Lotus Shipping Company Limited Procedure: LP 06: OFF - CREW-03

    Uploaded by

    Анжела Ованесян
    This document contains the employment form for deck cadet Beka Kirkitadze of Georgia. It lists his personal details, qualifications including certificates of competency, medical certificates, and sea service experience aboard the tanker MT Cadet. His qualifications and certificates were verified by the manning agent and crew manager as authentic and his background check was found satisfactory. The candidate was approved for employment by the Lotus Shipping Company.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5

    LOTUS SHIPPING COMPANY LIMITED PROCEDURE: LP 06

    OFF.CREW-03 SEAMAN EMPLOYMENT FORM

    JOINING RANK: DECK CADET

    SEAFARER’S PERSONAL DETAILS


    SURNAME: Kirkitadze NAME: Beka NATIONALITY: Georgian

    DATE OF BIRTH: 27/10/1997 FATHER’S NAME: Murman MARITAL STATUS: Single

    PLACE OF BIRTH: Khelvachauri MOTHER’S NAME: Nana NO OF CHILDREN:

    ADDRESS: Batumi, Urekhi #35 TEL.NO: MOBILE: +995574479356

    +995574479356

    EMAIL: SKYPE:

    NEAREST AIRPORT: Batumi [email protected]


    international airport

    NEXT OF KIN/RELATION: CONTACT No:

    PHYSICAL APPEARANCE
    HEIGHT WEIGHT OVERALL SIZE SHOES SIZE

    (IN CM) (IN KGRS) (EU)

    1.64 81 Xl 40

    Issue No. 03 / Date: 01.05.2019 AUTHORISATION: QSE Page 1 of 5


    LOTUS SHIPPING COMPANY LIMITED PROCEDURE: LP 06

    OFF.CREW-03 SEAMAN EMPLOYMENT FORM

    NATIONAL DOCUMENTS
    DOCUMENT NUMBER ISSUE EXPIRY DATE PLACE ISSUED
    DATE

    PASSPORT 18AF80035 03/10/2020 03/10/2030 Ministry of justice

    NATIONAL SEAMAN’S GE018785 29/12/2020 29/12/2025 Georgia


    BOOK

    RANK OF NATIONAL
    LICENSE:

    FLAG ENDORSEMENTS
    GRADE NATION NUMBER ISSUE DATE EXPIRY DATE

    COC

    GMDSS

    SEAMAN’S BOOK

    BASIC TANKER SAFETY

    ADVANCE OIL TRAINING

    ADVANCE CHEMICAL
    TRAINING

    SSO/SSA/SDSD

    NATIONAL LICENSES AND TRAINING CERTIFICATES

    COURSE CERTIFICATE NUMBER ISSUE DATE EXPIRY DATE

    COC (Certificate of MTA-00-012614 30.12.2020 25.12.2025


    Competency)

    GMDSS

    BASIC TRAINING FOR OIL OCG01-133010 16.12.2020 13.11.2025


    AND CHEMICAL TANKER

    ADVANCE OIL TANKER


    TRAINING

    Issue No. 03 / Date: 01.05.2019 AUTHORISATION: QSE Page 2 of 5


    LOTUS SHIPPING COMPANY LIMITED PROCEDURE: LP 06

    OFF.CREW-03 SEAMAN EMPLOYMENT FORM

    ADVANCE CHEMICAL
    TANKER TRAINING

    BASIC SAFETY TRAINING BST01-133013 16.12.2020 13.12.2025

    (Personal Survival Techniques-


    Firefighting- First aid - Personal
    Safety & Social Responsibilities)

    PROFICIENCY IN SURVIVAL FRB01-133009 16.12.2020 02.12.2025


    CRAFT & RESCUE BOATS
    ADVANCED FIRE-FIGHTING

    MEDICAL FIRST AID

    MEDICAL CARE

    SHIP SECURITY OFFICER

    SHIP SECURITY SEC01-133012 16.12.2020 18.11.2025


    AWARENESS

    DESIGNATED SECURITY SEC01-133012 16.12.2020 18.11.2025


    DUTIES

    ARPA

    (Automatic Radar Plotting Aids)

    ECDIS (Electronic Chart Display


    and Information Systems)

    ECDIS Type Specific Training


    (JRC for Lotus vessels)

    BTM / BRM (Bridge Team


    Management/Bridge Resource
    Management)

    ERM (Engine Room Resource


    Management)

    RISK ASSESSMENT

    INCIDENT INVESTIGATION

    SHIP HANDLING AND


    MANOEUVRING

    SHIP SAFETY OFFICER

    MEDICAL CERTIFICATES

    Issue No. 03 / Date: 01.05.2019 AUTHORISATION: QSE Page 3 of 5


    LOTUS SHIPPING COMPANY LIMITED PROCEDURE: LP 06

    OFF.CREW-03 SEAMAN EMPLOYMENT FORM

    ISSUE DATE EXPIRY DATE

    PRE-EMPLOYMENT
    MEDICAL EXAMINATION

    D&A TEST

    ISSUE DATE EXPIRY DATE

    PRE-EMPLOYMENT BLOOD
    ACCUMULATION TEST

    YELLOW FEVER CARD 26.02.2021 UNLIMITED

    ENGLISH KNOWLEDGE FAIR: GOOD: X VERY GOOD:

    FOR OFFICERS ONLY

    CHEMICAL TANKER EXPERIENCE FOR CREW MATRIX

    TIME IN RANK : TIME ON CHEM/TANKERS: TIME ON ALL TANKER TYPES:

    (Actual sea service) (Actual sea service) (Actual sea service)

    SEA SERVICE RECORD

    VESSEL’ RANK OPERATOR TYPE DWT FLAG YEAR M/E SIGN SIGN OFF
    S NAME BUIL TYPE
    T ON DATE

    DATE

    MT CADET D/CADET BSMA TANKER 947 GEORGIA 1977 01.09.2018 01.03.2019

    Issue No. 03 / Date: 01.05.2019 AUTHORISATION: QSE Page 4 of 5


    LOTUS SHIPPING COMPANY LIMITED PROCEDURE: LP 06

    OFF.CREW-03 SEAMAN EMPLOYMENT FORM

    REFERENCES
    COMPANY COMPANY

    COMMENTS COMMENTS

    CERTIFICATES’ AUTHENTICITY CHECK Completed by the Crew Manager, when recruitment is conducted directly
    by the Company. Completed by the Manning Agent, when the recruitment is conducted by the Manning Agent and verified
    by the Crew Manager.
    Authenticity check conducted for certificates:
    CONDUCTED BY MANNING AGENT (Name/Position)
    DATE ☐ Satisfactory ☐ Unsatisfactory
    RESULTS
    VERIFIED BY CREW MANAGER (Name)
    DATE RESULTS ☐ Satisfactory ☐ Unsatisfactory

    BACKGROUND SECURITY CHECK Completed by the CREW MANAGER, when recruitment is conducted directly by the
    Company. Completed by the Manning Agent, when the recruitment is conducted by the Manning Agency and verified by the CREW MANAGER.
    Policy Record Provided by the Seafarer Yes ☐ / No ☐
    CONDUCTED BY MANNING AGENT (Name/Position)
    DATE RESULTS ☐ Satisfactory ☐ Unsatisfactory
    VERIFIED BY CREW MANAGER (Name)
    DATE RESULTS ☐ Satisfactory ☐ Unsatisfactory

    APPROVAL OF CANDIDATE:

    LOTUS OFFICE REVIEWED BY: LOTUS OFFICE APPROVED BY:

    CREW MANAGER (Name & signature) OPS/TECH MANAGER (Name & signature)

    Issue No. 03 / Date: 01.05.2019 AUTHORISATION: QSE Page 5 of 5

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