Академический Документы
Профессиональный Документы
Культура Документы
ACADEMIC ACHIEVEMENTS:
ELEMENTAL 1992-1998 nuestra señora del rosario
HIGH SCHOOL 1999-2003 jose buenaventura sepulveda
UNIVERSITY 2007-2012 universidad tecnologica del peru
MARINE SCHOOL 2007-2012 universidad tecnologica del peru
SURVIVAL CRAFT AND RESCUE BOATS PANAMA March 23, 2009 3//23/2014
WATCHKEEPING
FIRE FIGHTING
MEDICAL CARE
MASTER - NO LIMIT
ISPS / MTSA
ONBOARD EXPERIENCE (At least last five years. First last ship)
SHIP [& Motor, for Engineers] TYPE DWT RANK FROM TO
CONT. 16500 CHIEF MATE 3/9/1985 5/24/1985
16500 CHIEF MATE 3/9/1985 5/24/1985
CAPTAIN 3/9/1985 5/24/1985
ATLANTIC EXPRESS/MAN 5L60 Chef Eng 12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
12/30/1899 12/30/1899
TOTAL ONBOARD (Years) 0.62
POSITIONS OF RESPONSIBILITIES HISTORY FROM TO
Port Captain and Personnel Manager Today
xxxxx xxxx
xxxxxxxxxx
xxxxxxxxxx
Other Areas of Interest:
LANGUAGES
Spanish and english
Additional Documentation:
YELLOW FEVER VACCINATION x Additional information upon request x
HEALTH EXAM x
By my signature, I am confirming that the provided information is true and I give permission for its
verification through the provided references or even within the marine industry
Signature
NAME
HEALTH HISTORY RH Group O+
Have you ever signed off from a ship due to Medical reasons,
Y
Please mark "Y" if applicable. If YES Provide details
Name of the vessel Date of incident Brief Decription(Injury/Illness/accident)
M/V XXXXXXX IMO #######
Did you suffer or Are you Presently suffering from any Disease likely to render you unfit for Service at Sea
y
or
Are yu under any type of medical treatment? If
Are you addicted to alcohol or drugs of any kind. y y
"YES", please provide information
(d) Have you suffered from following(Please mark "Y" if applicable)
Did you ever undergo
Malaria x Diabetes x Epilepsy y Nervous Disability N y
psychiatric treatment :
TRAVEL DOCUMENTS
Passport No. Date of Issue Date of Expiry Place of Issue Country
Dec/23/2012
US Visa No.(C1D) Date of Issue Date of Expiry Place of Issue Other VISA VISA number
x x x x
Physical data
Overall Suit Size Shoe Size
Height 1.78 mts Weight 75.5 Kgs L 12
S, M, L, XL, XXL 6, 7, 8, etc.
BODY MASS INDEX HAIR EYE
(BMI)
28 COLOR
Brown
COLOR
black Special marks Lunar en la cara
COMPANY REFERENCES
S/N Name of the company Person in charge Position Phone No E-Mail Address
1
5
PERSONAL REFERENCES
S/N Name of the company Person in charge Position Phone No E-Mail Address
1
5
INFORMACION DE LA COMPAÑIA (no modificar el formato)
1 12544564555
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
HISTORIA DE EMBARQU
EMPEZAR POR EL ULTIMO EMBA
ar el formato) INFORMACION DEL BUQUE
PARTICULAR PARA
E-MAIL BUQUE CUBIERTA ING
DWT MAIN ENGINE
TOTAL
RIA DE EMBARQUE
POR EL ULTIMO EMBARQUE
QUE INFORMACION TIEMPO ABORDO
TIPO (CUB) RANGO
DESDE HASTA TOTAL
o o
POWER (ENG) POSICION ABORDO Mes en letras MESES DIAS
0
0
0
TOTAL 0 0
RAZON DEL TERMINO DEL CONTRATO O EMBARQUE