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  • Wpif-8.5-01 - Application Form (Offshore)

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    Bvln Sask
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    This document is an employment application form for the position of Second Officer submitted by Sravan Kumar Bhemavarapu. It includes his personal details like name, date of birth, passport information, contact details, qualifications and certifications, medical history, and sea service experience. He holds a B.Sc in Nautical Science and various maritime certifications including COC, COP, GMDSS, and training in areas like firefighting and lifeboat operations. His sea service details are provided in a table listing vessels worked on along with ranks held, trading areas and duration of employment.

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    Application form

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    Wpif-8.5-01 - Application Form (Offshore) Copy

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    This document is an employment application form for the position of Second Officer submitted by Sravan Kumar Bhemavarapu. It includes his personal details like name, date of birth, passport information, contact details, qualifications and certifications, medical history, and sea service experience. He holds a B.Sc in Nautical Science and various maritime certifications including COC, COP, GMDSS, and training in areas like firefighting and lifeboat operations. His sea service details are provided in a table listing vessels worked on along with ranks held, trading areas and duration of employment.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    17 views2 pages

    Wpif-8.5-01 - Application Form (Offshore)

    Uploaded by

    Bvln Sask
    This document is an employment application form for the position of Second Officer submitted by Sravan Kumar Bhemavarapu. It includes his personal details like name, date of birth, passport information, contact details, qualifications and certifications, medical history, and sea service experience. He holds a B.Sc in Nautical Science and various maritime certifications including COC, COP, GMDSS, and training in areas like firefighting and lifeboat operations. His sea service details are provided in a table listing vessels worked on along with ranks held, trading areas and duration of employment.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 2

    Columbia Aurus Ship Management Pvt. Ltd.

    Employment Application Form -Offshore

    Application For Position Second Officer


    INDos No 10NL1514 Skype ID Nil
    Nearest International Airport Visakhapatnam
    Surname Middle Name Name Date of Birth Place of Birth Nationality
    Bhemavarapu Sravan Kumar 13-Jun-88 Srungavarapukota Indian

    Passport Z6596370 Issue 7/Feb/2022 Expiry 6/Feb/2032 Issued at Visakhapatnam


    Continuous Discharge Certificate Issue 5/Sep/2022 Expiry 4/Sep/2032 Issued at Mumbai
    Yellow Fever 249 Issue 15/Mar/2013 Expiry Unlimited Issued at Visakhapatnam

    Contact Details - +91- 9699979390


    Permanent Address Next of Kin Wife
    H No 16-67/2, Kapu Street, Srungavarapukota Address : H No 16-67/2, Kapu Street, Srungavarapukota
    Vizianagaram, AP - 534145
    Email : satyaveniy1993@gmail.com
    Postal Code 535145 Mobile -9699979299 Relationship Wife
    Tel Email bvlnsask88@gmail.com Mobile -6281272639

    Highest Qualification: B.Sc Nautical Science


    Marlin English Test:
    COC Grade : COC Capacity / Limitation :

    Licenses Certification Certificate No Issued Validity Issued By Authority


    COC (Certificate of Competency)
    COP (Certificate of Proficiency)
    Deck / Engine Rating Watchkeeping
    GMDSS (GOC)
    GMDSS Endorsement

    STCW Certification Certificate No Issued Validity Issued By Authority


    BST
    PST
    PSSR
    PSCRB
    BFF
    FPFF
    AFF
    EFA
    MFA
    MEDICARE
    STSDSD
    SSO
    BTM
    BRM
    ERM
    SHIP HANDLING /MANOEUVRING
    ECDIS
    ARPA
    ROC

    Additional Certificates Certificate No Issued Validity Issued By Authority


    Food Handling
    High Voltage
    BOSIET
    HUET/EBS
    Rigging & Slinging
    H2S Awareness
    Helicopter Landin Officer(HLO)
    Helideck Assistant(HAD)
    FRC/FRB
    Dynamic Positioning(Unlimited)
    Dynamic Positioning(Advanced)
    Dynamic Positioning(Basic)
    DP Maintenance & Technical Course
    Additional Course

    Medical History
    Has the applicant has ever signed off from a vessel on medical grounds. If yes, please furnish details below

    Height in cms: Weight in KG: BMI :


    Safety Shoe Size: Pant Size: Shirt Size:
    References :
    Name of the Company Name of the Company
    Contact Person Contact Person
    Contact Details Contact Details
    WPIF-8.5-01 01ST JULY 2022 REV – 0
    Details of Sea service
    In chronological order - Last vessel on top

    Scope of No. of
    # Operators /Company Vessel Type of vessel DP Type GT KW Engine Rank Trading Area Operations Charter From To days
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    Non-Disclosure Declaration: Information pertaining to seafarer which is consider as “seafarers right to privacy and the need to protect of his/her personal data” will not be disclosed by CASM Team to any third party for any purpose, other
    than any need of disclosure from related statutory/ regulatory/concerned authorities.

    Signature Date
    * If one page is not enough, please make copies of this page and attach to the application sheet.

    WPIF-8.5-01 Date- 01ST JULY 2022 Rev- 0

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