C. V.

Employees Application for Deck and Engineer Department/Aplicao para pessoal de Convs / Mquinas / Camara Name & Surname/Nome Completo Nationality/Nacionalidade Date & Place of Birth/Data de Nascimento Passport Number/Passaporte No. Date Passport Issue/Data emisso do passaporte Place Passport Issue/Local de emisso do passaporte Date Passport Expire/Data vencimento do passaporte Father Name & Surname/Nome do pai completo Mother Name & Surname/Nome da me completo Address/Endereo Telephone/Telefone Rank/Funo Languages/Idiomas S E A Start/Incio T I M E/Tempo de Embarque (Commence by the last embark/Comece pelo ltimo embarque ) End/Fim Rank/Funo Vessel/Embrcaro Type/Tipo Kw /Trg (D)/AB Company

STCW VI/1.1 VI/1.2 VI/1.3 VI/1.4 VI/2 VI/3 VI/4 IV/2

C E R T I F I C A T E S Certificates/Certificados Certificate of Competency/Certificado de competencia Survival at Sea/Sobrevivencia pessoal Basic Fire Fighting/Combate a incendio First Aid/Primeiros socorros Social Responsibilities /Responsabilidades sociais Survival craft Proficiency Sobrevivencia pessoal avanado Advanced Fire Fighting/Combate a incendio avanado Medical Care /Cuidados Mdicos avanado G.M.D.S.S General Radio Operator/Operador de GMDSS Radar Arpa Others Courses/Outros Cursos Tankers Familiarization/Familiarizao de tanques (AFNT) ISPS IOPP DP Courses (Basic/Advanced) Yellow Fever Vacination/Vacinao Febre Amarela Vanuatu License/Certificato de competencia de Vanuatu Vanuatu GMDSS/Certificado de GMDSS de Vanuatu Belize License/Certificado de competencia de Belize Belize GMDSS/Certificado de GMDSS de Belize Others/Outros

Issue/Emisso

Expiration/Vencimento