Application Form

 

 

 

 

 

 

Personal Data

Rank Applied For

3rd Engineer

Date Available to Start

IST AUG 2018

Last Name

 PAUL

First Name(s)

 DHRUBA CHANDRA

Date of Birth

25-01-1972

Place of Birth

BRIDHYANAGAR

 

 

Nationality

Indian

 

 

 

Permanent Address

 

 

Street Address

 VILL:- BRIDHYANAGAR,

P.O. - RANIR BAZAR 

City: AGARTALA

 

Province/State : Tripura

Country: India

Postal Code : 799035

 

 

 

Secondary Address Mailing Address Current Address

Street Address

 

City

 

Province/State 

Country

Postal Code 

 

Primary Phone No.

+91-9612516346 / +91-7085546830

 

Alternate Phone No.

 

Email

paul.dc09@gmail.com

MUI Membership Validity Date

31-12-2011

Height

171 Cm

Weight:

65 Kg

Boiler Suit Size

L - size

Shoe Size

6

 

Travel Documents & Vaccinations

Documents

 Number

Date of Issue 

DD-MMM-YYYY

Place of Issue

Expiry Date

DD-MMM-YYYY

Office Use

Orginals Verified

Passport

Z 4478754

 06/12/2017

 KOLKATA

05/12/2027

 

CDC (National)

 MUM89231

 25.02.2015

 MUMBAI

24.02.2025

 

US Visa C1/D

 201Φ293378 Φ Φ Φ1

 27.10.216

 KOLKATA

24.10.2021

 

Certificate of Competency Grade…….……

NEW CLASS-IV- COC-95Z-5407

 19.02.2015

 KOLKATA

12.12.2019

 

Hong Kong Endorsement Grade…………….….

 

 

 

 

 

Yellow Fever

 002579-2011

29.02.2012

KOLKATA

29.02.2022

 

Emergency Contacts

Name of Next of Kin : K.C. Paul

 

Relationship: Brother

 

Contact Information for Next of Kin

Phone No.

+91-9402141044

Street Address: Swagat Bunglow-4, New CG road,

P.O.- Chandkheda, Pin-382424

 

City: Ahmedabad

 

Marital/Civil Status Single Married Divorced Separated
Common-Law Widow

Effective Date

13-05-2007

 

Family Data (if applicable)

Surname

First Name(s)

Relationship

Place of Birth

Date of Birth

DD-MMM-YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pre Sea Training / Apprenticeship

Name of Institute / College

From

DD-MMM-YYYY

To

DD-MMM-YYYY

Type of Degree

Marks

Patel Engineering works

23.08.1996

22.08.1998

 

 

 

 

 

 

 

 

 

 

 

 

 

Shore Employment

Employer Details

From

DD-MMM-YYYY

 

To

DD-MMM-YYYY

Rank / Nature Of Work

Patel Engineering Works 

 05.05.1994

 31.12.1995

Trainee Engineer/Ship repair 

Patel Engineering Works 

01.01.1996

21.08.1996

Junior Engineer

 

 

 

 

 

Last Two Employers' Name, PIC, and Contact No.

 

Company

Contact Name

Number

1

MSC SHIP MANAGEMENT

M PATRA 

 

2

ORIENT EXPRESS

JC RAJAN 

 

Previous Sea Service (Data Commencing from Last Vessel)

 

 

 

 

 

ATTACHMENT 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sl. No

Name of Owners / Manager

Name of Vessel

Type

DWT

TEU

Engine Type

BHP/KW

UMS Y/N

Rank

From

To

Total MM/DD

Reason for S/Off

1

V. SHIPS INDIA PVT. LTD

M. V. EDEN BAY

BULK CARRIER

17018 GRT

 

MITSUI B&W 6S42MC 2 STROKE MCR 5850 KW@129RPM

5850 KW

N

 

24-12-2016

06-07-2017

 

 

2

DYNACOM TANKERS MANAGEMENT PVT.COM

M.V.GLYFADA 1

BULK CARRIER

41342 GRT

 

HHM-MAN-B&W 5S60MC MK6 8833KW.SINGLE SCREW 11845

11845

YES

3RD ENGG

03-04-2015

26-08-2015

 

 

3

IRSL

M.V ARTAVAND

BULK CARRIER

39424(GRT)

 

HYUNDAI MA B&W, 5S60MC MK6, 895O KW

12170

YES

3rd ENGG

01.07.2013

25.11.2013

 

 

4

So.co.GEM SAM ship management

M.V. GRETA

BULK CARRIER

31261(GRT)

 

 M.A.N B&W6S 50 MC, 2 Stroke, Single acting crosshead

9480

 

3rd ENGG

03.03.2012

21.08.12

 

 

5

MSC SHIP MANAGEMENT

M.V. MSC ASTRID

CONTAINER (UMS)

 56983.02

 

 MAN B&W7K90MC-C,31920KW

43379

 

3rd ENGG

29.10.2010

04.03.2011

 

 

6

MSC SHIP MANAGEMENT

M.V. MSC HINA

CONTAINER

 21370

 

 B&W-2STROKE TYPE: 9K80GF80/160-4

21600

 

4th/3rd ENGG

15.07.2008

05.02.2009

 

 

7

MSC SHIP MANAGEMENT

M.V. MSC PATRICIA

CONTAINER

 18235

 

 SULZER 5RTA 58, 7000 KW.CPP

9383.38

 

4th ENGG

17.09.2007

27.11.2007

 

 

8

MSC SHIP MANAGEMENT

M.V. MSC AGATA

CONTAINER

 28422

 

 B&W DIESEL A/S 5L80GFCA

15400

 

4th ENGG

08.10.2006

20.02.2007

 

 

9

ORENT EXPRESS

M.V. OLE EXPRESS

CONTAINER

 

 

 MAN-5K SZ 70/125 BL 7600 KW

10187.67

 

4th ENGG

13.10.2005

16.03.2006

 

 

10

ORENT EXPRESS

M.V. ORIENT AISHWARYA

CONTAINER

 

 

 MITSUBISHI-7UEC-45/115H-7000 BHP

7000

 

4th ENGG

25.04.2005

11.07.2005

 

 

11

UNIVAN SHIPMAMAGEMENT

MSC EMILIAS

CONTAINER

 14738

 

 MAN K7Z 78/155F 2 STROKE TURBOCHARGED

12250

 

5th ENGG

21.04.2002

23.09.2002

 

 

12

 ESSER SHIPMANAGMENT

 M.V NAND NEETI

 BULK CARRIER

 

 

  SULZER 6RTA 58-8500BHP

 8500

 

 5th ENGG

20.05.2001 

30.12.2001 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

 

 

 

 

14

 

 

 

 

 

 

 

 

 

 

 

 

 

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STCW & OTHER TRAINING AND VERIFICATION

ATTACHMENT 2

 

 

 

 

 

 

 

 

 

 

Applicant's name:

Dhruba Chandra Paul

Rank :

3rd Engineer

Date : 27-01-2012

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Candidate to fill

 

 

For Office use

 

Details of Courses & Certificates

Number

Date of Issue

Date of Expiry

Issued by

FlagState
Reqt

copy recd

verified with
original

Remark

verified by

Date

Advanced Fire Fighting / AFF

0222/015/2003 

 19.04.2003

 

Naval maritime academy  

 

 

 

 

 

 

Proficiency in Survival Craft & Rescue Boat / PSCRB

0282/016/2003 

 25.04.2003

 

Naval maritime academy  

 

 

 

 

 

 

Medical First Aid/Medicare

 0164/017/2003

 01.05.2003

 

Naval maritime academy 

 

 

 

 

 

 

Personal Safety & Social Responsibility (PSSR)

98PRE811 

 03.03.1999

 

SCI maritime training institute 

 

 

 

 

 

 

Radar Observer / ARPA

 

 

 

 

 

 

 

 

 

 

Radar Simulator / RANSCO

 

 

 

 

 

 

 

 

 

 

GMDSS

 

 

 

 

 

 

 

 

 

 

Hazmat Course

 

 

 

 

 

 

 

 

 

 

Bridge Team Management

 

 

 

 

 

 

 

 

 

 

Ship Handling Simulator

 

 

 

 

 

 

 

 

 

 

Engine Room Simulator

ERSM00170611 

[Management level]

 02.09.2011

 

College of maritime studies and research, Kolkata 

 

 

 

 

 

 

SSO

 

 

 

 

 

 

 

 

 

 

Others