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II.3.7.1.1 Crew Application
II.3.7.1.1 Crew Application
II.3.7.1.1 Crew Application
PERSONAL DETAILS
SURNAME Gavric
GIVEN NAME Josip
DATE / PLACE OF BIRTH 07.07.1979, Doboj
NATIONALITY Croatian
INSERT PHOTO
MARITAL STATUS Married GENDER male
HEIGHT (cm) 178
WEIGHT (kg) 84
DATE OF AVAILABILITY 5/10/2023
CONTACT INFORMATION
RELATIONSHIP Wife
SURNAME Rogic Gavric
GIVEN NAME Mihaela
NOK ADDRESS Trampov breg 20, Rijeka
NOK CONTACT NUMBER 385915148334
PRE-SEA EDUCATION
NAME OF SCHOOL / ACADEMY QUALIFICATION / DEGREE FROM TO
Maritime University Rijeka BSC of Nautical Studies 9/1/1999 7/1/2002
TRAVEL DOCUMENTS
CERTIFICATES
Page 1 of 4
REVISION 0 II.3.7.1.1. CREW APPLICATION - BASIC DATA
Document Owner Managing Director ZCM / Fleet Personnel
IMO CERTIFICATES
HUMAN ELEMENT, LEADERSHIP & MANAGEMENT (HELM) NMMSGMRM002 Glasgow 7/29/2016 N/A
Page 2 of 4
REVISION 0 II.3.7.1.1. CREW APPLICATION - BASIC DATA
Document Owner Managing Director ZCM / Fleet Personnel
I certify that the above information and attached sea service record are true and accurate; and that any false information would lead to the nullity and denial of this application.
That all Certificates of Competence or Licenses presented have never been revoked and/or suspended.
I agree that during this application process, I will be subjected to a computer based Professional and English Language assessment test. The results of which form part of this
application. I agree that previous employers may be contacted for information concerning my employment record and hereby release them from any liability and confidentiality in
providing such information.
In compliance with the Data Privacy Act of 2012 (RA 10173), I agree that ALL information regarding myself may be shared for hiring / processing and documentation purposes with
the principal and all internal interested parties, Philippine Government Agencies (e.g. POEA, OWWA, DFA, MARINA, SSS) and other external interested parties (e.g. AMOSUP, P&I
Clubs and Correspondents, HMO, Flag State Authorities, Medical Assessment and Diagnostic Centers).
DATE 11/27/2023
PRINT NAME + SIGNATURE
Page 3 of 4
REVISION 0 II.3.7.1.1. CREW APPLICATION - SEA SERVICE
Document Owner Managing Director ZCM / Fleet Personnel
MANAGER OWNER RANK VESSEL NAME FLAG TYPE OF VESSEL DWT GRT M.E. TYPE M.E. PS/KW NO. OF CARGO SIGN ON * SIGN OFF NO. OF SIGN OFF
(MAKER) CRANES (dd/mm/yy) (dd/mm/yy) MONTHS REASON
NORTHERN MARINE MANAGEMENT STENA PROMAN MASTER STENA PROSPEROUS CYPRUS CHEMICAL TANK 49988 29884 MAN 7600 1 3/14/2023 4/20/2023 1 End of contract
NORTHERN MARINE MANAGEMENT NAVIGATOR GAS MASTER NAVIGATOR GLOBAL INDONESIA LPG TANKER 25000 16822 MAN 7000 1 10/18/2022 11/12/2022 1 End of contract
NORTHERN MARINE MANAGEMENT NAVIGATOR GAS MASTER NAVIGATOR GLOBAL INDONESIA LPG TANKER 25000 16822 MAN 7000 1 8/2/2022 10/13/2022 2 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PREMIUM BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 1/12/2022 4/6/2022 3 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA CONQUEROR BERMUDA OIL/CHEMICAL T 48769 27512 MAN 8580 1 5/23/2021 8/27/2021 3 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PRIMORSK BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 10/22/2020 1/18/2021 3 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PRIMORSK BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 2/27/2020 7/13/2020 4 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PRIMORSK BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 9/8/2019 12/1/2019 3 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PROVENCE BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 3/7/2019 3/25/2019 1 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PROVENCE BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 10/14/2018 1/31/2019 3 End of contract
NORTHERN MARINE MANAGEMENT STENA BULK MASTER STENA PROVENCE BERMUDA OIL/CHEMICAL T 65125 36168 MAN 2X7860 2 4/20/2018 7/18/2018 3 End of contract