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    SHOEI Biodata

    Uploaded by

    Shorya Chauhan

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd

    SHOEI Biodata

    Uploaded by

    Shorya Chauhan
    5 views4 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    XLS, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    5 views4 pages

    SHOEI Biodata

    Uploaded by

    Shorya Chauhan

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    of 4

    BIO-DATA CHECK BY

    IN CHARGE

    Picture
    Manning Agent:

    Date:

    Rank: Vessel:

    Name:
    (Surname) (Given Name) (Middle Name)

    Address: Telephone:
    Birth Date: Birthplace: Nationality:
    Civil Status: Weight: kg. Height: cm BMI: Shoe Size: cm Clothes Size :
    Name of Wife (or Nearest Relative) and Address Relation:
    Name: Number of Child (Age):
    (Surname) (Given Name) (Middle Name)

    Address: Telephone:
    1.EDUCATIONAL ATTAINMENT
    Year School Course Finished

    2.LICENCES
    License Rank Number Date Issued Expiry Date Issued By
    National
    Panama
    Panama GMDSS
    Panama SSO
    Liberia
    Liberia GMDSS
    Liberia SSO
    3.CERTIFICATE
    Certificate Number Date Issued Expiry Date Issued By
    Passport
    U.S. C1/D Visa
    Seaman's Book/National
    Seaman's Book/Panama
    Seaman's Book/Liberia
    Australian Crew Maritime Visa
    4.OTHER CERTIFICATES(MARINA/SOLAS/MARPOL/OTHERS)
    Certificate Number Date Issued Expiry Date Remarks
    SDSD
    Watchkeeping / STCW
    Basic Training
    Survival Craft & Rescue Boat
    Fire-Fighting Course
    Medical First Aid Course
    PSSR
    Radar Observer
    Certificate of Endorsement
    Certficate of Competency
    SSO(Ship Security Officer) Course /
    GMDSS
    Satellite Communication Course
    G.O.C.
    Medical Care
    JRC ECDIS SPECIFIC 1
    JRC ECDIS SPECIFIC 2
    FURUNO ECDIS FEA
    FURUNO ECDIS FMD
    TOKIMEC
    ECDIS GENERIC
    HIGH VOLTAGE
    NC I Ship's Catering Service
    NC II Ship's Catering Service
    NC III Ship's Catering Service
    5.PHYSICAL INSPECTION/YELLOW CARD
    Certificate Number Date Issued Expiry Date Remarks
    Physical Inspection
    Yellow Fever

    6.ENGLISH / JAPANESE LINGUISTICS


    Evaluation English Japanese
    Read and Write Excellent/Good/Acceptable/Poor/Unsuitable
    Speak and Listen Excellent/Good/Acceptable/Poor/Unsuitable

    7.TRAINING / EXPERIENCE FOR SAFETY MANAGEMENT SYSTEM


    Type Date Period Evaluation
    Training for SMS (System of SHOEI KISEN CO.) /
    Experience of SMS (System of SHOEI KISEN CO.) /
    Experience of SMS (System of Others) /

    Welding Class Evaluation


    Ability Excellent / Good / Acceptable / Poor / Unsuitable

    8.SEAMAN'S HISTORY
    Sea service (within the last ten years) listed most recent service last.
    Note: 1)Indicated whether vessel is M/V(Motor Vessel),S/S (Steam Ship) or S/T(Steam Turbine),etc.
    2) Under TYPE indicate whether Bulk, Log, VLCC, Chemical, LPG, PCC, Reefer, etc.
    3) For Deck Officers and Ratings indicate Gross Tonnage of Vessel.
    4) For Engine Officers and Rating indicate Gross Tonnage and Engine Type with HP (Horsepower).

    Vessel's Name Type Gross Tonnage & TEU Manning Agent Sign on Reason/Sign off
    Flag Rank Engine Type / HP Sign off period

    REMARKS AND RECOMMENDATIONS:


    Crew's Name: Presenter:

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