S.C. AB CREWING S.R.L.

EMPLOYMENT APPLICATION FOR SHIP PERSONNEL

F 01-02

Application For Employment As: Engine Ca et !ate A"aila#le $or %oining: &'(&)(*)&+

P E R S O N A L P A R T I C U L A R S F A M I L Y

SURNAME: Militaru Middle Name: !ate o" #irt$: %&'()'%**% Marital Status: Single Address: Tul+ea- Str' Mi$ai .itea/u- Nr' 0&

First Name: George Nationalit : Romanian Pla+e o" #irt$: Tul+ea Name o" S,ouse:

Tele,$one No: Mo1ile: ()20343*2& Pass,ort No' (2%733&3) !ate o" Issue: 028(480(%3 US .isa Seaman #oo: No' 3%%40CT !ate o" Issue: %(8(480(%3 Medi+al +erti"i+ate: 3(27 !ate o" issue: (08(480(%3 #lood t ,e: 6eig$t: %)2 +m No

Nearest International Air,ort #u+$arest 5 Oto,eni 6'Coanda Pla+e o" Issue: Tul+ea !ate o" E9,ir : 028(480(%7 !ate o" E9,ir : Pla+e o" Issue: Constanta !ate o" E9,ir : (08(480(%2 !ate o" E9,ir : (08(480(%7 Clot$es si/e ; M < S$oe si/e: 4%

Gi=e ,arti+ulars o" our immediate "amil mem1ers and indi+ate our relations$i, >it$ t$em' Name8 Relations$i, !ate o" 1irt$ O++u,ation

EMERGENCY Ne9t o" ?in: Relations$i,: Tele,$one No' 6ome: L I C E Certi"i+ate National Li+en+e Grade Tele,$one No' O""i+e8Mo1ile: LICENCE PARTICULARS Cert No Issue !ate Address:

Pla+e o" Issue

.alidit

S.C. AB CREWING S.R.L.

F 01-02

N Endorsement S Tan:ers +erti"i+ate E Li@' gas tan:ers +ert C$emi+al tan:ers +ert Fast res+ue 1oat +ert' Ot$er "lag endorsem' Certi"i+ate o" Engine Cadet Com,eten+

43)*(

%(8(480(%3

Constanta

3%8%080(%&

S'T'C'A' COURSES Re" No Personal sur=i=al te+$ni@ues8Sur=i=al at Sea C O U R S E S Pro"i+ien+ in sur=i=al +ra"t and res+ue 1oatsot$er t$an "ast res+ue 1oats First Aid SeaB 9 C Ad=an+ed Medi+al CareB C Fire Fig$ting B9 C Ad=an+ed Fire Fig$ting B C Radar O1ser=ers Radar Simulator A'R'P'A' G'M'!'S'S 5 G'O'C' Tan:er "amiliari/ation Tan:er S,e+iali/ed training C$emi+al Tan:ers Ad=an+ed Training Li@ue"ied gas ad=an+ed training !angerous Cargo Maritime Englis$ D 6uman Relations$i, P'S'S'R' Fast Res+ue #oat Leader Pre=ention O" Pollution ROERO8Passenger S$i,s Pro"i+ien+ #ridge Team Management Pro"i+ien+ in Fast Res+ue #oats Ot$er ((%723 (%8(380(%3 ((%723 !ate o" Issue (%8(380(%3

((%723 ((%723

(%8(380(%3 (%8(380(%3

S,MMARY OF E-PERIENCE. in mont/s0

EFPERIENCE AS #UL? CARRIER ORE CARRIER CONTAINER CARRIER C6EMICAL TAN?ER REEFER OIL TAN?ER GENERAL CARGO OT6ERS TOTAL

S.C. AB CREWING S.R.L.

F 01-02

CPT C8O 08O 38O C!T

C8E %8E 08E 38E E8E ENGINEER APPLICANT TYPE OF ENGINE !URATION;Mont$s< NA.IGATING APPLICANT TYPE OF .ESSEL !URATION;Mont$s< #UL? CARRIER GENERAL CARGO CONTAINER CARRIER C6EMICAL TAN?ER REEFER OIL TAN?ER OT6ERS;S,e+i" < YES 8 NO YES 8 NO !uration ;Mont$s< NATIONALITY: MONT6S:

TOTAL

MAN #DA SULGER MA? STEAM TUR#INE8OT6ERS U'M'S' CRANE EFPERIENCE ;TYPE8MA?E< E9,erien+e >it$ Inmarsat E9,erien+e >it$ Multinational Cre> Reason For Lea=ing Last Com,an : A$et$er Agreea1le To A++e,t One Ran: Lo>er A$et$er Agreea1le To Hoin .essel Trading In Aar Gone

YES 8 NO YES 8 NO

Signature Inter=ie> !ate: Le=el o" Englis$ Inter=ie>er notes: Fleet Personnel !e,artment Notes: 8 %( Inter=ie>ed 1 : A,,earan+e: 8 %(

!ate o" a,,li+ation Result: Attitude: 8 %(