SEAMAN’S APPLICATION FOR EMPLOYMENT

APPLICANT’S NAME _____________PETER ARCADIE ALEXANDRU_____________________________

POSITION APPLIED FOR: First Choice_______DECK CADET_____ Second Choice______OS_______ AVAILABLE SINCE: ___________ANY
TIME___________

GENERAL INFORMATION

ROMANIAN ADDRESS ZIP Code Telephone No.

_______29,Cornisa Bistritei ,bl 9,ap 9__________________________________________600072_______0724000581____________
_______________ ___________________

Date of Birth ________20.06.1995___________ Place of Birth ___________Bacau__________Age ____23______ Height _____190

cm____Weight_____88 kg______
Complexion ______________ Coverall Size__________L_______ Pants Size ___34_________ Shoe Size __45___
Father’s Name ______Arcadie Alin_____________________ Mother’s Name ______________Gabriela_______________ Civil Status
_________Single_______
Contact Person _______Peter Arcadie Alin_____________ Telephone No. _______0755660896________________________ Relation
__________________Father_______

Language Spoken ___Romanian,English____ ______________

DOCUMENT STATUS
Seaman Book No. ________34959CT________Date Issued_______21.08.2018_____________ Expiration Date
___21.08.2020___________Rank_________Deck Cadet_________
Passport No__________053289578__________ Date issued______20.10.2015______________ Expiration
Date_______20.10.2020_______Place Issued_________Bacau___
Yellow Fever Validity___21.12.2025______________________US Visa Validity____________20.11.2023____________________

PLEASE ANSWER THE FOLLOWING QUESTIONS:

1) Are you willing to accept assignments in any part of the world?

_________________Yes___________________________________
2) Are you willing to accept any assignment in war zone areas?
__________________Yes____________________________________
3) Of what Seaman Union are you a member?
_____________None______________________________________________________
4) Have you been involved in I.T.F. cases?_________________No_____________________________________________________
5) Have you been discharged for a cause?
______________No________________________________________________________
6) Do you have any kind of sickness in present or in the past?
__________No_____________________________________________
7) Were you recommended for the job by someone? If yes, please affix his name and position as well as the last vessel he was
connected with.
________________________________________No_____________________________________________________________
_
8) Do you faithfully comply with the company’s policies consistent with International Rules and Regulations?
_________Yes_________
9) Do you read, understand and agree with the Owner’s/Manager’s of the vessel on the SAFETY MANAGEMENT AND POLLUTION
AVOIDANCE POLICY?
______________Yes______________________________________________________________________
 10) Are you aware that if you violate the Drug and Alcohol Policy, you are subject to dismissal and payment of all repatriation costs?
_____________________________________________Yes___________________________
11) List names of relatives or recommenders working with this Agency.
_______________None___________________________________
12) Are you aware that if you provide InterOrient with false information, you are liable for dismissal at any stage of your employment?
_______________________________________________________Yes______________________________________________
__

APPLICANT’S CERTIFICATION

I hereby certify that the foregoing information is complete, true and correct. I understand that misinterpretation or omission of facts may
result to the rejection of my application form or my dismissal from the ship. I also certify that I have not paid nor promised to pay any
monetary or other considerations in exchange of my employment. I further confirm that I understand, speak and write English language.

__________Peter Arcadie Alexandru __________

Signature Over Printed Name

EASTERN
MEDITERRANEAM
1 Owners ARSVOM 2 Owners MARITIME LTD
Rom. Agency ARSVOM Rom. Agency PHOENIX SHIPPING
Ship's Name HERCULES Ship's Name SEA LUCK III
Ship' Type TUG Ship' Type OIL TANKER
Ship's Flag ROMANIA Ship's Flag MALTA
GRT/ DWT 2388/3795 GRT/ DWT 57314/105869
Year Built 1988 Year Built 2003
Rank Deck Cadet Rank Deck Cadet
Period ( from-until) 05.10.2016-25.01.2017 Period ( from-until) 13.05.2017-13.11.2017
Reason for Sign-off End of Contract Reason for Sign-off End of Contract
Only for Engine Crew/Electrician Only for Engine Crew/Electrician
Engine Type/HP Engine Type/HP
Auxiliary Engine Auxiliary Engine
Gear Type on Deck Gear Type on Deck
Engine Automation Type Engine Automation Type
Lathe Machine Experience(Yes/No) Lathe Machine Experience(Yes/No)
Pipe Fitting Experience(Yes/No) Pipe Fitting Experience(Yes/No)
Welding Experience(Yes/No) Welding Experience(Yes/No)

ZEARBORN
3 Owners SHIPMANAGEMENT 4 Owners
ZEARBORN
SHIPMANAGEMENT
Rom. Agency ROMANIA Rom. Agency
RICKMERS
Ship's Name DALIAN(ZEA DALIAN) Ship's Name
Ship' Type MPC Ship' Type
Ship's Flag MAJURO Ship's Flag
GRT/ DWT 23110/29827 GRT/ DWT
Year Built 2004 Year Built
Rank Carpenter Rank
Period ( from-until) 09.12.2018-04.05.2019 Period ( from-until)
Reason for Sign-off End of Contract Reason for Sign-off
Only for Engine Crew/Electrician Only for Engine Crew/Electrician
Engine Type/HP Engine Type/HP
Auxiliary Engine Auxiliary Engine
Gear Type on Deck Gear Type on Deck
Engine Automation Type Engine Automation Type
Lathe Machine Experience(Yes/No) Lathe Machine Experience(Yes/No)
Pipe Fitting Experience(Yes/No) Pipe Fitting Experience(Yes/No)
 Welding Experience(Yes/No) Welding Experience(Yes/No)

5 Owners 6 Owners
Rom. Agency Rom. Agency
Ship's Name Ship's Name
Ship' Type Ship' Type
Ship's Flag Ship's Flag
GRT/ DWT GRT/ DWT
Year Built Year Built
Rank Rank
Period ( from-until) Period ( from-until)
Reason for Sign-off Reason for Sign-off
Only for Engine Crew/Electrician Only for Engine Crew/Electrician
Engine Type/HP Engine Type/HP
Auxiliary Engine Auxiliary Engine
Gear Type on Deck Gear Type on Deck
Engine Automation Type Engine Automation Type
Lathe Machine Experience(Yes/No) Lathe Machine Experience(Yes/No)
Pipe Fitting Experience(Yes/No) Pipe Fitting Experience(Yes/No)
Welding Experience(Yes/No) Welding Experience(Yes/No)

TRAINING AND CERTIFICATES (FOREIGN/LOCAL)

Training Certificate
Type Center no. Date issued Valid Until
ENDORSEMENT
Basic Safety Training for Ratings with PSSR
Personal Safety and Social Responsibility CERONAV 00004370 15.05.2015 14.05.2020
Personal Survival Techniques CERONAV 00004370 15.05.2015 14.05.2020
Proficiency in Survival Craft and Rescue Boats
Medical First Aid CERONAV 00004370 15.05.2015 14.05.2020
Medical Care
Advanced Fire Fighting
Fire Fighting for Ratings CERONAV 00004370 15.05.2015 14.05.2020
Maritime English
Prevention and Fighting Marine Pollution/MARPOL
Transport and Handling Dangerous Goods/HAZMAT
Radar ARPA
Radar Navigation and Radar Plotting
GMDSS
GOC
Bridge Team Management
Inert Gas System Operation
COW
Tanker Familiarization CERONAV 007431 17.03.2017 17.03.2022
OIL Tanker Familiarization
GAS Tanker Familiarization
Chemical Tanker Familiarization
Specialized Training for Tankers
Specialized Training for Oil Tankers/STOT
Specialized Training for Gas Tankers/ LPG
Specialized Training for Chemical Tankers/STCT
Certificate for Tankers CERONAV 06694 22.03.2017 17.03.2022
Certificate for Oil Tankers
Certificate for Chemical Tankers
Certificate for Liquified Gas Tankers
Certificate for Proficiency in Fast Rescue Boats
Proficiency in Fast Rescue Boats
RO-RO Passenger Ships Familiarization CERONAV 00003003 22.12.2016 22.12.2021
Ship Security Officer

LICENCES (LOCAL/FOREIGN)
TYPE POSITION License no. Date issued Valid Until
Romanian License
Panama License
Liberian License
Bahamas License
Marshall Is. License
St. Vincent License
Cyprus License
Malta License
Cayman Is. License

SEAMAN BOOKS (Foreign) Rank Number Date issued Valid Until

Panama S.B.
Barbados S.B.
Bahamas S.B.
Marshall Is. S.B.
Liberian S.B.
St. Vincent S.B.
Cyprus S.B.
Cayman IS. S.B.
Malta S.B.