АPPLICATION FORM

III ENGINEER IMMEDIATELY

Positions applied for: Date of readiness:
BEHARA VENKATA SAI AVINASH
Surname: Name:
BEHARA RAJASEKHAR BEHARA S V JANAKI
Father’s name: Mother’s name:
09/02/1994 INDIAN
Date of birth: Nationality:
Place of birth: VISAKHAPATNAM Marital status: SINGLE
No. of Children under 18
(City, Country)
FLAT NO 510, CHALAMAJI ALLIANCE 2, SRAMASAKTI NAGAR, NEAR
Home Address: SARADAPEETAM,CHINNAMUSIDIWADA,VISAKHAPATNAM
531173 9346874969
Home Zip : Contact Phone:
[email protected]
E-mail: Skype/Telegram:
BEHARA RAJASEKHAR FATHER
Next of kin: Relation:
FLAT NO 510, CHALAMAJI ALLIANCE 2, SRAMASAKTI 9390801569
Next of kin’s address: NAGAR, NEAR Next of kin’s phone No
SARADAPEETAM,CHINNAMUSIDIWADA,VISAKHAPATNA
M
178 73KG LARGE
Height (cm): Weight (kg): Size of Overall (EUR):
BROWN BLACK 9
Eyes Colour: ISH Hair Colour: Shoes (EUR):

Marine Education
Name of maritime college or academy GARDEN REACH SHIP BUILDERS & ENGINEERS- From 2017
KOLKATA
Department MARINE ENGINEERING Till 2019

PASSPORTS and CERTIFICATES

DOCUMENT NUMBER ISSUED DATE VALID UNTIL PLACE

TRAVEL PASSPORT: B8780159 02.02.2024 01.02.2024 VISAKHAPATNAM

SEAMAN’S BOOK (SID): KOL110730 09.10.2018 08.10.2028 KOLKATA

CIVIL PASSPORT:

U.S. VISA:

OTHER VALID VISA:

RHA-A-088040 09.10.2024 09.10.2029 HONDURAS

CERTIFICATE OF COMPETENCY # 1

THIRD III/1 (THIRD ENGINEER)

RANK / CAPACITY
ENGINEEER
ENDORSEMENT OF CERTIFICATE # 1

CERTIFICATE OF COMPETENCY # 2

RANK / CAPACITY

ENDORSEMENT OF CERTIFICATE # 2

Date: 25.10.2022
Prepared by: Quality Manager. Approved by: Crewing Director. Validated by: Quality Manager. 1/5
 АPPLICATION FORM

CERTIFICATE NUMBER ISSUED DATE VALID UNTIL PLACE

PERSONAL SURVIVAL TECHNIQUES PST 4140386112230116 21.04.2023 20.04.2028 BEHARA MARITIME INSTITUTE-
VIZAG

FIRE PREVENTION & FIRE FIGHTING (FPFF) 4140386122230116 21.04.2023 20.04.2028 BEHARA MARITIME INSITUTE-
REFRESHER VISAKHAPATNAM
PSSSR PSSR0191819272 11.04.2018 NA MERCANTILE MARINE ACADEMY-
KOLKATA
ELEMENTARY FIRST AID EFA0211819184 18.04.2018 NA MERCANTILE MARINE ACADEMY-
KOLKATA
PROFICIENCY IN SURVIVAL CRAFT 2010016211200619 19.07.2022 26.01.2026 ASHA MARINE -MUMBAI

ADVANCED FIRE FIGHTING 2010016311200336 27.01.2022 NA BP MARINE-MUMBAI

MEDICAL FIRST AID MFA/0724/AD/3367 29.06.2024 03.07.2024 LATIN INDO MARINE -NOIDA

MEDICAL CARE

SHIPS SECURITY OFFICER B8780159 09.10.2024 09.10.2029 HONDURAS

DESIGNATED SECURITY DUTIES STS0441800019 16.04.2018 UNLIMITED MERCANTILE MARINE ACADEMY-

KOLKATA
SECURITY AWARENESS

SHIPS SAFETY OFFICER / ISM

RADAR NAVIGATION, RADAR PLOTTING AND USE

OF ARPA
DANGEROUS & HAZARDOUS CARGOES

BRIDGE TEAM MNGT

ENGINE ROOM RESOURCE MNGT ETM/0724/AD/3367 10.07.2024 15.07.2024 LATIN INDO MARINE -NOIDA

ECDIS GENERIC

ECDIS SPECIFIC

BASIC TRAINING FOR OIL & CHEMICAL TANKER 4050515111240103 28.09.2024 HIMT-VIZAG
CERTIFICATE
ADV. TRAINING FOR OIL TANKER CERTIFICATE

ADV. TRAINING FOR CHEMICAL TANKER

CERTIFICATE
BASIC TRAINING FOR OIL AND CHEMICAL TANKER COPDGSOAC24147 07.10.2024 06.10.2029 MMD-MUMBAI
- ENDORSEMENT 987
ADV. TRAINING FOR OIL TANKER -ENDORSEMENT

ADV. TRAINING FOR CHEMICAL TANKER -

ENDORSEMENT
ENGINE ROOM SIMULATOR (OPERATIONAL) 3030083121210301 05.05.2021 NA HOON MARITIME-KOLKATA

HIGH VOLTAGE EL. EQUIPMENT

COOK CERTIFICATE

YELLOW FEVER CERTIFICATE Z2416572 19.05.2019 UNLIMITED VISAKHAPATNAM

COVID-19 VACCINATION CERTIFICATE

Date: 25.10.2022
Prepared by: Quality Manager. Approved by: Crewing Director. Validated by: Quality Manager. 2/5
 АPPLICATION FORM

FOREIGN SEAMAN’S ID / RECORD BOOKS

FLAG NUMBER ISSUED DATE VALID UNTIL PLACE

HONDURAS CDC BOOKLET 051940 10.09.24 10.92029 HONDURAS

SID CARD C31554041 12.01.2021 11.0.2031 CHENNAI

Date: 25.10.2022
Prepared by: Quality Manager. Approved by: Crewing Director. Validated by: Quality Manager. 3/5
 АPPLICATION FORM

PREVIOUS SEA SERVICE

FROM TO POSITION SALARY NAME OF SHIPOWNER TYPE OF TYPE OF BUILD DWT BHP FLAG CREWING
VESSEL VESSEL ENGINE YEAR AGENT
21.09.2023 27.01.2024 1500 GBP VENUS II GOLDEN STRAND GUARD ALPHA BW 1973 495 775KW PANAMA SEA SAIL SHIPPING
SOLE OFFSHORE VESSEL SERVICES
ENGINEE LIMITED-
R IRELAND
02.10.2019 14.08.2020 450 USD MV MY LAMA EASTERN STAR BULK CARRIERMAN B&W 2005 28409 MAN B&W BELIZE DESTAN SHIP
TME SHIPPING 6S42MC-C MANAGEMENT
6150KW

Date: 25.10.2022
Prepared by: Quality Manager. Approved by: Crewing Director. Validated by: Quality Manager. 4/5
 АPPLICATION FORM
BRIEF INFORMATION ABOUT PREVIOUS EMPLOYERS

COMPANY PERSON IN CHARGE CONTACT DETAILS (Phone Number, e-mail)

I hereby confirm that above information is true and correct to the best of my knowledge. I understand that this information will be held in the computer database due to my real or possible
employment. Signing it, I willfully give my permission to collect and process my personal information and to use it in all and legal way. I give my permission for my personal information to be
provided to the possible employers and any other persons, if such need arises for my employment.

Date: 02.11.2024 Signature:

Date: 25.10.2022
Prepared by: Quality Manager. Approved by: Crewing Director. Validated by: Quality Manager. 5/5