Name Rank English  
D.O.B P.O.B PHOTO
ID NO. Age
Address Tel
Name of Family Connection
Height(cm) Weight(kg) Blood Type Shoes No.
Graduate /Time/ Education  
CERTIFICATES TYPE
 NUMBER
 DATE/OLACEOFLSSUE
 EXPIRED DATE

Passport

Seafarer’s Passport

C.of.C.

Seaman’s Record Book

GMDSS(GMDSS)

PNM/LIB/GMDSS Certificate

Others

CERTIFICATES TYPE    NUMBER/ ISSUE DATE/

Professional Training

Basic Safety Training

Proficiency in Survival Craft and Rescue Boats

Advanced Fire-fighting Training

Proficiency in Medical First Aid

Medical Care On Board(Master & C/O only)

Radar Observation & Plotting & Radar simulator

Certificate For Arpa Simulator

Special Training For Seafarers

Oil Tanker Familiarization/Operations

LPG Familiarization/Operations

Chemical Tanker Familiarization/Operations

Name of Vessel Rank Date of Sign-on

Date of Sign-off

GT/VSL Type

 HP/M/E Type Flag
 Area

Name of Company