Orient Ship Management & Manning Pvt.Ltd

Orient Ship Management & Manning Pvt. Ltd.
Licence No. RPSL-MUM-019 Validity: 15.02.2021 / Photo
/ 601, Global Chambers,
Off-New Link Road, Andheri (W), Mumbai-400 053. India
Tel: 26736459 (6 Lines)
Email:

Website: / 276, R.P.S. Flats,
Sheikh Sarai, Phase-1,
Near A.P.J. School,
New Delhi – 110017, India
Tel: 26017457 / 26016065
Fax: 26017456
Email:

FOR DECK& ENGINEER OFFICERS OFFSHORE VESSELS

Date of Availability / Post Applied for / Height / Weight
SUR NAME: / FIRST NAME: / MDDLE NAME:
Nationality: / Date of Birth: / Place of Birth:
Blood Group: / Shoe Size: / Boiler Suit Size:

DETAILS OF CERTIFICATES OF COMPETENCY

Date Passed / Date of Issue / Date of Expiry / Certificate Number / Rank / Issued by
INDIAN C.OC.
UK/OTHER C.O.C
PANAMA C.O.C
DP LIMITED CERTIFICATE
DP UNLIMITED CERTIFICATE
Document Number / Date of
Issue / Date of
Expiry / Place of
Issue / EMMIGR CLR
Yes / No
PASSPORT
U.S.A. VISA
CDC (INDIAN)
CDC (PANAMA)
CDC (NORWAY)
CDC (OTHER)
Yellow Fever
Number of blank pages in the passport

RECORD OF EDUCATIONAL QUALIFICATION

Name of Institute / Percentage of Marks / Year Passed / Course Duration
SCHOOL FINAL
COLLEGE
PRE – SEA
INDOS NUMBER

RECORD OF PREVIOUS SERVICES

Shipping Company
(Full Name) / Name of Ship / Flag / Type / DWT/
GRT / Main Eng. & Type / BHP / Rank / Date
From to

DETAILS OF S.T.C.W. & VALUE ADDED COURSES / CERTIFICATES

Place of
Issue / Date of
Issue / Date of Expiry / Issued
By / Certificate
Number
1. Proficiency in Survival Craft and Rescue Boats Other than
Fast Rescue Boat (PSCRB)
2. Proficiency in Fast Rescue Boat
3.Advance Fire – Fighting (AFF)
4. Medical First aid (MFA) / Master’s Medical Care
5. Personal Safety & Social Responsibilities (PSSR)
6. Familiarisation Training in MLC 2006
7. Ship Security Officer (SSO) / Security Training with
Designated Security Duties
8. Ship Safety Officer
9. Radar Observer Simulator Course (ROC)
10. ARPA Simulator Course
11. Radar ARPA & Nav. Simulator Course (RANSCO)
12. Ship Manoeuvering Simulator & Bridge Team Work (SMS)
13. GMDSS Certificate
14. GMDSS Endorsement
15. C.O.C. Revalidation Certificate
16. Bridge Team Management (BTM)
17. Bridge Resource Management (BRM) / Maritime Resource
Management (MRM)
18.Vessel Resource Management (VRM)
19. Electronic Chart Display & Information System (ECDIS)
Course
20. Oil Pollution Act (OPA-90)
21. D.P. Basic (Induction) Course
22. D.P. Advanced (Simulator) Course
23 D.P. Technical and Maintenance Course .
24. NIS Log Book
25. IMCA Log Book
26. Basic Offshore Safety Induction & Emergency Training
27. Helicopter Underwater Escape Training
28 Helicopter Landing Officers Course (HLO)
29.Heli Deck Assistance (HDA)
30. Offshore Emergency Helideck Team Member (OEHTM)
31. Offshore Emergency Helideck Team Leader (OEHTL)
32. Risk Assessment & Risk Management
33. Incident Investigation & Root Cause Analysis Course
34. Vessel Inspection Preparation – Operation / Management
35. Internal Auditors Course
Local Address in Mumbai & Contact No. / Permanent Address, Contact No. (with STD Code) & Email
Next of Kin / Relation-ship / DOB / Passport Number / Date of
Issue / Date of
Expiry / Issuing Authority / E.C.N.R. / USA VISA
Expiry Date

Correct and detail information about Next of Kin is very important from legality point of view. Next of Kin includes dependent

parents, spouse and children.

ACKNOWLEDGEMENT: (1) COPY RECEIVED (2) ALL INFORMATIONS FURNISHED BY ME ARE TRUE & MY CERTIFICATES ARE GENUINE .

Date Rank Signature
SEAMAN (REG.No) / M.U.I MEMBERSHIP No

NOTE NO.1 : THE APPLICATION FORM IS FREE OF COST

NOTE NO.2: NO PROCESSING FEES OR RECRUITMENT CHARGES ARE LIABLE.

NOTE NO.3: EMPLOYMENT SUBJECT TO CONFIRMING THE STATUTORY REQUIREMENTS & OWNER’S APPROVAL.

NOTE NO.4: INFORMATIONS IN THIS FORM SHALL BE KEPT PRIVATE & CONFIDENTIAL.

NOTE NO:5: THIS APPLICATION WILL BE ACCEPTED AND PROCESSED WITHOUT ANY BIAS BASED ON APPLICANTS CASTE, CREED, SEX.

RELIGION, POLITICAL OPINION, NATIONALITYOR SOCIAL ORIGIN

OSMM-APLCN (09/17)