Photo

APPLICATION FOR EMPLOYMENT

GENERAL

Position applied for 1/E

Surname/Name SCORCEALOF DUMITRU
Place /date of birth 18/12/1962-CONSTANTA
Nationality ROMANIAN
Marital status SINGLE
Numbers of children 1
Full style address&telephone numbers DIONISIE CEL MIC 61,BL.66,AP 16
+40 241 694 302,+40 740 757 973
Next of kin,relationship,address SCORCEALOF DUMITRA

PHYSICAL APPEARANCE

Color of hair Color of eyes Height(cm) Weight(cm) Shoes size Overall size
BROWN BROWN 178 90 41 43

TRAVELLING AND SAILING DOCUMENTS

Documents Number Issued by Date of issue Date of expiry
Seaman book 511CT CONSTANTA 22/06/2002 22/06/2005
Licence 502 CONSTANTA 22/06/2002 24/07/2006
Passport 002541436 CONSTANTA 28/06/1996 28/06/2006
GMDSS
Endorsment ABV 99 12970 CONSTANTA 16/06/2004 09/03/2009

KNOWLEDGE
Please mark with the symbol “x” wherever applicable.
Language English French German Spanish Other
Level Fluent Fair Fluent Fair Fluent Fair Fluent Fair Fluent Fair
Spoken X
Read X
Written X

APPLICANT’DECLARATION

Please answer the following questions Yes/no If yes,please provide details

Have you previous injuries or sickness? NO
Premature termination of contract? NO
Have been dismissed or logged for mischief? NO
Any criminal offence? NO
Have been refused entry by any country? NO
Any special diet or religious restrictions? NO
Any medical restrictions/drugs/allergies? NO
Any alcohol drinking habits? NO
Any past history of medical/mental condition? NO
Can we make references check with ex YES
employers?

COURSES ATTENDED

Please mark with the symbol “x” wherever applicable.

Survival at sea/personal survival course X
Prevention and fighting of marine pollution X
Fire prevention and fire fighting aboard ship (basic) X
 Fire prevention and fire fighting (advanced) X
First aid at sea (basic) X
First aid at sea (advanced) X
Proficiency in survival craft x
Advanced fire protection
Safety in oil tanker
Inert gas system operation
Bridge team management
Basic tanker (Pet)
Basic tanker ( Chem, LPG, LMG)
Advanced tanker (Pet)
Advanced tanker(Chem, LPG, LMG)
G.M.D.S.S.
P.S.S.R. X
Radio telephone
Electronic navigation system
Maritime English X
Crude oil washing
Dangerous cargo X
Radar simulator
A.R.P.A. X
Cookery certificate
Crowd management training RO RO pass Ships
Safety tr. for pers. prov. dir. service to pass. Ships
Ship fam. tr. RO RO pass Ships
Proficiency in :pass,Safety,cargo safety, hull integr.
Proficiency in crisis manag. And human behavior
Proficiency in fast rescue boat X
Ship security officer X

I hereby declare and confirm that all above mentioned and enclosed information’s is true,
and I take full responsibility of any arrest or delay of the ship on board of which I will sign
on, in case this arrest and /or delay occur /arises because of my documents and /or
behavior.

Date Signature
 SEA SERVICE RECORD for SCORCEALOF DUMITRU Rank 1/E

N Type Vessel Name GRT/Engine/KW Rank From To Agent Principal Sign off
o reason
1. BK 1/E 06/2004 11/2004 NAVINA GREECE END
THEMIS 17.055 DTW/SULZER MARITIME
(YANMAR) 12 000HP
2. BK SENATOR 3 500 1/E 06/2003 02/2004 LIBRA GREECE
DDTW/MITSUBISHI/
7 800 HP

3. BK IOANNIS 10000/HANSIN/4700 1/E 14/10/02 20/04/03 BRIGHT ALFA SOLD SHIP

/ CARRIER
GREECE
4. CTK ALEXANDROS T 15000/MAN/10 000 1/E 12/11/00 19/07/01 PHOENIX ESCOSPIRI END
T

5. CG INTEROCEAN 1 7800/SULZER 1/E 07/1999 07/2001 MIRAY GREECE

RDA56/1,33 END
6. CG SANMARINA 1 7800/SULZER 2/E 05/1998 04/1999 SANMARIN SANMARIN END
RDA56/1,33 A A

CRANES ELECTRICE,AUTOMATION,DERRICK HYDRAULIC,CPP EXPERIENCE