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Application Form / Personnel Data Update Form |
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Post applied for: |
CHIEF ENGINEER/Technical Suprintendent |
Willing to accept lower rank ? |
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no |
Available From: |
9/1/2017 |
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PERSONAL PARTICULARS (AS IN PASSPORT) |
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First Name |
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Middle Name |
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Last Name/Surname |
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MANEYKANDAN |
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LASKSHMANAN |
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Nationality |
INDIAN |
Date of Birth |
21/01/1978 |
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P l a c e o f B i r t h |
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PORT BLAIR |
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Height |
154 |
Weight |
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Smoker / Nonsmoker |
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(In CMS) |
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(In KGS) |
78 |
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NONSMOKER |
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Boiler Suit |
XL |
Shoe |
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Yellow Fever Valid till: |
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Size : |
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Size : |
8 |
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22/11/2021 |
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Permanent Address : |
B/0 L.KRISHNAMURTHY |
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Present Add: |
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PIGMY AGENT ,SYNDICATE BANK |
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PORTBLAIR |
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DO |
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City : |
ANDAMAN |
Telephone : |
9626467400 |
City : |
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Post Code : |
744101 |
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Post Code : |
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E-Mail : |
MARINEMANI@YAHOO.COM |
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Telephone : |
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Document |
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No. |
Issued |
Place |
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Valid Untill |
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Passport : Country |
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z2737439 |
11/28/2013 |
PORTBLAIR |
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Nov-23 |
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Seamans Book (CDC) : National |
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MS14580 |
8/3/2001 |
PORTBLAIR |
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3/8/2026 |
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Seamans Book (CDC) : Norwegian |
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Seamans Book (CDC) : Liberian |
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Seamans Book (CDC) : Panamian |
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Seamans Book (CDC) : Marshall Island |
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MH388283 |
2-Jan-13 |
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Other (CDC) : |
Liberia |
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21-Mar-13 |
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Nov-23 |
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Valid US Visa C1/D |
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Yes |
Valid Until : |
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Passport ECNR: |
Yes |
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Next to Kin: |
V.PRIYA |
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Relationship : |
WIFE |
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DOB : |
20/06/1985 |
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Address :SHREE ASTA LAKSHMI ILLAM,CHATHAM OFFSHORE ROAD,HADDO,A&N ISLANDS-744102 |
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Telephone : |
9176528829 |
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………………..Family Data……………….. |
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Relationship |
First Name |
Last Name |
DOB |
Passport No |
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Place Issued |
Valid Untill |
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Spouse |
VISWANATHAN |
PRIYA |
20/06/1985 |
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Child M |
LAKSHMANAN |
HARSHID |
11/10/2012 |
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Child F |
SAI SRADHA |
SHREE |
8/24/2016 |
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Indicate Type of Valid Visa : |
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USA |
CANADA |
BRAZIL |
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UK |
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OTHERS |
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Please consider period on board |
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ACADEMIC QUALIFICATION |
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Diploma / Degree |
Institution / University |
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Year of Passing |
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Class |
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B.E |
MADURAI KAMARAJ UNIVERSITY |
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1999 |
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1ST |
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TRAINING & APPRENTICESHIP |
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Diploma / Degree |
Institution / University |
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Year of Passing |
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Class |
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HINDUSTAN SHIPYARD LTD |
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2000 |
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1ST |
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CERTIFICATES / COURSES : |
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Highest Competency Certificate Held : |
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Issuing Authority |
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Grade |
Certificate No. |
DOI |
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Place Issued |
Valid Untill |
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National (Country) |
INDIAN |
CLASS 1 |
95W-6589 |
20-12-2010 |
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CHENNAI |
5/14/2020 |
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Liberian |
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Panamian |
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Marshall Island |
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Norwegian |
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Hongkong |
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CLASS 1 |
NL091834 |
16-Aug-15 |
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HONG KONG |
16-Aug-15 |
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Others |
SINGAPORE |
CLASS 1 |
COE-E0074016 |
5TH APR 2012 |
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SINGAPORE |
16-Aug-15 |
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LIST OF S.T.C.W. / OTHER COURSES DONE |
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Courses |
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Cert No. |
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Date of Issue |
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Place of Issue |
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1) Advanced Fire Fighting |
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AFF/B06/04 |
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13-07-02 |
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HIMT,CHENNAI |
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2) Fire prevention & Fire Fighting |
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FPFF/B84/17 |
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18/10/00 |
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HIMT,CHENNAI |
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3) Proficiency in Survival Craft & RB |
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PSCRB/0302/2002 |
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19/07/02 |
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AMET,CHENNAI |
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4) Personal Survival Techniques |
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PST/B140/06 |
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21/10/00 |
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HIMT,CHENNAI |
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5) Elementary / Medical First Aid |
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MFA/B199/06 |
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6/7/2002 |
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HIMT,CHENNAI |
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6) Ship Capt. Medical (Medicare) |
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7) CHEMCO |
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SCTO/2394/2009 |
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28/05/2009 |
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OERC MUMBAI |
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8) Chemical Tkr Familiarisation Course |
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CTF/01/035/225 |
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5/10/2001 |
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CMA,CHENNAI |
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9) TASCO |
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TASCO/B75/06 |
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14/10/06 |
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HIMT,CHENNAI |
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10) Oil Tkr Familiarisation Course |
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TFC/B92/4 |
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27/10/01 |
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HIMT,CHENNAI |
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11) PSSR |
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PSSR/B270/09 |
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21/10/00 |
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HIMT,CHENNAI |
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12) LCHS : (Management / Operational) |
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13) GMDSS |
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14) Ship Manouvering Simulator Courses |
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15) Radar Observer Course / ARPA |
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16) Radar Simulator Course |
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17) C.O.C. Revalidation Course |
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18) Other (Specify) |
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PSF/B170/721 |
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20/10/06 |
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CTM/CHENNAI |
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19) INDOS NO. |
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99EL4552 |
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MUMBAI |
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Dangerous Cargo Certification : |
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1. Endorsement on NATIONAL Certificate |
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Level |
Number |
DOI |
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Place Issued |
Valid Untill |
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Petroleum |
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MANAGEMENT |
DCE02CHN16001070 |
24-Oct-16 |
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CHENNAI |
24-Oct-21 |
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Liquified Gas |
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Liquid Chemicals |
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MANGEMENT |
DCE02CHN16001071 |
24-Oct-16 |
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CHENNAI |
24-Oct-21 |
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2. Endorsement / Cert. Obtained (Liberian, |
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Level |
No. / Issuing |
DOI |
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Place Issued |
Valid Untill |
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etc.) qualifying as (Capacity) |
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Authority |
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CHEMICAL AND OIL |
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MANAGEMENT |
TEM-0007303 |
20-Dec-10 |
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SINGAPORE |
31-Dec-16 |