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    Application Form Engineers Elec Off Etr

    Uploaded by

    Hasiba Mostora
    Orient Ship Management & Manning Pvt. Ltd. is a ship management and manning company based in Mumbai and New Delhi, India. The document appears to be an application form for engineers, electrical officers, and electro-technical ratings. It requests personal details such as name, nationality, date of birth, certificates, education history, previous work experience, medical certifications, and emergency contact information. The form notes that no processing fees or recruitment charges are required to apply and that employment is subject to statutory requirements and owner approval.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Application Form Engineers Elec Off Etr

    Uploaded by

    Hasiba Mostora
    51 views2 pages
    Orient Ship Management & Manning Pvt. Ltd. is a ship management and manning company based in Mumbai and New Delhi, India. The document appears to be an application form for engineers, electrical officers, and electro-technical ratings. It requests personal details such as name, nationality, date of birth, certificates, education history, previous work experience, medical certifications, and emergency contact information. The form notes that no processing fees or recruitment charges are required to apply and that employment is subject to statutory requirements and owner approval.

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    Orient Ship Management & Manning Pvt. Ltd. is a ship management and manning company based in Mumbai and New Delhi, India. The document appears to be an application form for engineers, electrical officers, and electro-technical ratings. It requests personal details such as name, nationality, date of birth, certificates, education history, previous work experience, medical certifications, and emergency contact information. The form notes that no processing fees or recruitment charges are required to apply and that employment is subject to statutory requirements and owner approval.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    51 views2 pages

    Application Form Engineers Elec Off Etr

    Uploaded by

    Hasiba Mostora
    Orient Ship Management & Manning Pvt. Ltd. is a ship management and manning company based in Mumbai and New Delhi, India. The document appears to be an application form for engineers, electrical officers, and electro-technical ratings. It requests personal details such as name, nationality, date of birth, certificates, education history, previous work experience, medical certifications, and emergency contact information. The form notes that no processing fees or recruitment charges are required to apply and that employment is subject to statutory requirements and owner approval.

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    © All Rights Reserved
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    Orient Ship Management & Manning Pvt. Ltd.

    Licence No. RPSL-MUM-019 Validity: 15.02.2021


    601, G l ob al Ch amb er s, 276, R.P .S . Fl ats ,
    O f f- New L i nk Road , And h er i (W ), Sh ei k h S ara i , Ph ase - 1,
    Mu mb a i - 400 053. In di a Nea r A.P .J . S ch ool , Photo
    T e l : 2673 64 59 (6 L i n es) New Del h i – 1100 17 , In di a
    E mai l : man n i n g@osm m. c o m T e l : 2601 74 57 / 2601 606 5
    c r ew i n g@ osm m. c o m Fax : 26017 45 6
    Web si te : www.osm m. c o m E mai l : d el h i @osm m. c o m
    FO R E NG I N EE RS, E L ECT R I CAL OFFI CE R & E LE CT RO T ECH CH N I C AL
    RAT I NG
    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:
    DE T AILS O F CE RT IFICAT E S O F CO M P E T E N CY
    Date of Date of Certificate
    Date Passed Rank Issued by
    Issue Expiry Number
    INDIAN C.O.C.
    UK / OTHER C.O.C.
    PANAMA C.O.C.

    Date of Date of Place of EMMIGR CLR


    Document Number
    Issue Expiry Issue Yes / No
    PASSPORT
    U.S.A. VISA
    CDC (INDIAN)
    CDC (PANAMA)
    CDC
    (NORWAY)
    CDC (OTHER)
    Yellow Fever
    Number of blank pages in the passport
    RE CO RD O F E DUCATIO NAL Q UAL I FICAT IO N
    Name of Institute Percentage of Marks Year Passed Course Duration
    SCHOOL FINAL
    COLLEGE
    PRE – SEA
    INDOS NUMBER

    RE CO RD O F PRE VIO US S E RVICE S


    Shipping Date
    DWT / Main Eng. &
    Company Name of Ship Flag Type BHP Rank From to
    GRT Type
    (Full Name)
    DETAILS OF S.T.C.W. & VALUE ADDED COURSES / CERTIFICATES
    Place of Date of Date of Issued Certificate
    Issue Issue Expiry By Number
    1. Proficiency in Survival Craft and Rescue Boats
    Other than Fast Rescue Boats (PSCRB)
    2. Advance Fire – Fighting (AFF)
    3. Medical First aid (MFA)
    4. Personal Safety & Social Responsibilities (PSSR)
    5. Specialised Tanker Safety Course (Oil) (TASCO) /
    Tanker Familiarization Course (OTFC)
    6. Specialised Chemical Tanker Course (CHEMCO) /
    Tanker Familiarization Course (CTFC)
    7. Specialised LPG Tanker Course (GASCO) /
    Tanker Familiarization Course (GTFC)
    8. DCE (OIL) Operation/Management (Strike out which is not applicable)
    9. DCE (CHEM) Operation/Management (Strike out which is not
    applicable)
    10 DCE(LPG) Operation / Management (Strike out which is not
    applicable)
    11. Ship Security Officer (SSO) / Security Training with
    Designated Security Duties
    12. C.O.C. Revalidation Certificates
    13. Certificate of Proficiency – For Electro Technical Rating
    14 Engine Room Team Management (ERM)
    15. E/R Simulator Course – Operation / Management
    16. Oil Pollution Act – OPA 90
    17. USA – HAZMAT
    18. Risk Assessment & Risk Management
    19. Incident Investigation & Root Cause Analysis
    20. TMSA familiarization
    21. Vessel Inspection Preparation – Operation / Management
    22. Passenger Ship Familiarisation
    23. Vessel Resource Management (VRM)
    24. Internal Auditors Course
    Local Address in Mumbai & Contact No. Permanent Address, Contact No. (with STD Code) & Email

    Relation- Passport Date of Date of Issuing USA VISA


    Next of Kin DOB E.C.N.R.
    ship Number Issue Expiry Authority 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, NATIONALITY OR SOCIAL ORIGIN

    OSMM-APLCN (09/17)

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