022 4748 4139
info@seawoodsmaritime.com

Registration Form

Personal Details
Name as in Passport *
Date / Place of Birth *
Permanent Address *
Current Address (if any)
Mobile No * Email ID *
Educational/ Technical Details
Qualification * School/College * From * To * Percentage/Grade *
Pre-sea Training Details
Pre-Sea Training / Apprenticeship * Institute/College * From * To * Percentage/Grade *
Identity Documents
Document Country Number Issue Date Expiry Date Place of Issue
Passport * Indian
Seaman’s Book Indian
Other
COE
Yellow  Fever
Do you hold a US Visa ‘C1/D? Issue Date: Expiry Date:
Indos. No.
Next of Kin Details
Pan Name of Kin Telephone No
Relationship Mobile No
Email Id Pincode
Address of next of Kin
Details of Courses & Certificates For Ratings
Courses Certificate No. Issued By Issue Date Expiry Date
Fire Prevention & Fire Fighting (FPFF)
Elementary First Aid (EFA)
Personal Survival Technique (PST)
Personal Survival & Social Responsibility ( PSSR)
ISPS Course
Oil Tanker Familiarization (OTFC)
DCE Oil – Support
Chemical Tanker Familiarization (CTFC)
DCE Chemical – Support
AB/ MM Course
Watch Keeping Certificate Ratings (Deck/Engine)
Pump Man Course
Cookery Course
MMD Cookery Certificate
Fitter Course / Class Cert.
ISPS Course
HAZMAT
ENCLOSED SPACE ENTRY
STSDSD (Security Training for Seafarers with Designated Security Duties)
SSO (Ship Security Officers)
H2S
HUET
COP (RATING)
BOSIET
PSCRB
MLC 2006 Food Handling & Hygiene
MLC Ship’s Cook
MLC MEDICAL
Sea Experience
Vessel Name Company Name Vessel Type GRT/NRT Rank Sign On Sign Off
Passport Size Photo * Aadhar Card *
Pan Card * Passport *
Signature *