CREWING / MANNING AGENT: QUEEN LIZ - ROMANIA

CURRICULUM VITAE AND SEASERVICE DETAILS

Rank:
Surname:
Date of birth:
Street/ Boulevard:
Zip code :
Phone number :

TEL:.0241549744
FAX: 0241512830
E-mail: office@queenliz.ro

Given Name:
Place of birth:
Number:
Town:

Seaman book
number

Place/Date issued

Date expires

Medical visit
SB issued

Yellow fever valid

until

E mail:

Passport
number

Place/Date issued

Date expires

U.S.A VISA

Place/Date issued

Date expires

Cert. of comp. Number

Rank

Endorsement number

Rank

Foreign endorsement

Number

Place/Date issued

Place/Date issued

Rank

Place/Date issued

Date expires

Date expires

Date expires

Language
English
Italian
German
French
Other
Speaking
Reading/Writing
Course attended:
Personal survival techniques
Medical first aid
Personal safety and social responsibilities on board ships
Maritime English
Prevention of pollution of the marine environment
Transport and handling of dangerous, hazardous and harmful cargoes
Advanced/ Basic fire fighting
Proficiency in survival craft and rescue boats, other than fast rescue boats
Medical care
Proficiency in fast rescue boats
Bridge team and Resource management
Engine team management
Radar ARPA, Operational Level
Radar ARPA, Management Level
G.M.D.S.S./G.O.C.
Ro-Ro Passenger Ships/ Passenger Ships other than Ro-Ro Passenger Ships
Ship Security Officer
Tankers Familiarization
Specialized Training for Oil Tankers
Specialized Training for Chemical Tankers
Specialized Training for Liquefied Gas Tankers
Ship Safety Officer
Operational use of Electronic Chart Display and Information System
Tanker management and self assessment
Ship handling and manoeuvring simulation
Familiarization with the requirements of ISM CODE, QMS/ ISO and EMS/ ISO
Dynamic Positioning
Security awareness training and security training for seafarers with designated security duties SSD

MANNING AGENT: QUEEN LIZ CONSTANTA - ROMANIA

CURRICULUM VITAE AND SEASERVICE DETAILS

Name of vessel

Vessel
type/DWT/ GRT

Engine type
KW/HP

Owners

Rank

Date signed
on

2 of 3

Date signed
off

Trading
area

Notes

Subsemnatul sunt de acord ca datele mele personale predate firmei SC QUEEN LIZ SRL (operator date personale nr.2461) sa poata fi transmise catre terti in strainatate. Am luat cunostinta
de dreptul la informare si accesul la baza de date a operatorului, conform Art. 12 18 din Legea 677/2001.
Semnatura aplicant:

MANNING AGENT: QUEEN LIZ CONSTANTA - ROMANIA

CURRICULUM VITAE AND SEASERVICE DETAILS

3 of 3

Subsemnatul sunt de acord ca datele mele personale predate firmei SC QUEEN LIZ SRL (operator date personale nr.2461) sa poata fi transmise catre terti in strainatate. Am luat cunostinta
de dreptul la informare si accesul la baza de date a operatorului, conform Art. 12 18 din Legea 677/2001.
Semnatura aplicant: