Rom Trust S.R.L.

Form F-01-1 - APPLICATION FOR EMPLOYMENT

(rev.2 / 20.02.2014)

SC ROM TRUST SRL prelucreaza datele cu caracter personal furnizate de dvs. prin acest document in scopul prezentarii candidaturii dvs. pentru o posibila angajare. Datele vor fi dezvaluite numai
potentialilor angajatori. Pe viitor, aceste date ne permit sa va tinem la curent cu activitatea noastra. In cazul in care nu doriti aceasta, nu va vom putea lua in considerare aplicatia si nu va vom
inregistra in baza noastra de date. Conform Legii nr.677/2001, beneficiati de dreptul de acces, de interventie asupra datelor, dreptul de a nu fi supus unei decizii individuale. Aveti dreptul sa va
opuneti prelucrarii datelor personale care va privesc si sa solicitati stergerea datelor din baza noastra de date. Pentru exercitarea acestor drepturi, va puteti adresa cu o cerere scrisa, datata si
semnata la sediul nostru. De asemenea, va este recunoscut dreptul de a va adresa justitiei. Datele dvs. vor fi transferate in statele Uniunii Europene in vederea unei posibile angajari.
Numr Registrul General Autoritatea Nationala de Supraveghere a Prelucrarii Datelor cu Caracter Personal: 22497.

Recomandat de Constandache Constantin

Family Name:
Timpu
Given Name: Ionel Laurentiu
Date and Place of birth:
26.01.1991 constanta
Height (m): 1.85 m
Wear glasses?

Weight(kg): 95
Dioptric left eye:

No

Overall size: L
Dioptric right eye:

Shoes size: 44

Fathers Name: Danut

Mothers Name: Lucica
Education:
UMC
Between years: 10-16
Rank/Rating: Engineer Ofiicer
Home address: str. Brotacei . nr 22 , Lumina ,Constanta
Phone no.1:
0724481565
Phone no.2 :
E-mail:
timpu.laurentiu@yahoo.com
good
working
Other
Language proficiency (delete as appropriate)
English:

photo

good

fluent

language:

MARITAL STATUS: single

Date/Place of birth:
Childrens Name
Date of birth
PERSONAL DOCUMENTS
National I.D. Card
Seamans Book
Passport
USA Visa
Australian MCV
Certificate of competency:
Rank & Number
Endorsement

NEXT OF KIN:

Family name:Efimov
Relationship:fiancee

Given name:cristina
Phone no.:0722803452

No.

Place issued

Date issued

Valid / Endorsed until

31977ct
052134597
20162428380001

constanta
constanta
bucuresti

07.07.16
15.10.13
30.08.16

08.05.18
15.10.18
28.08.21

62630

constanta

07.07.16

15.02.21

ABV 56549

constanta

07.07.16

15.02.21

I . M . O . S T C W 7 8 / 9 5 C E RT I F I C AT E S
Nr.
Date issued
Certificate

Certificate
Personal survival techniques
Basic fire-fighting
Medical first aid
P.S.S.R.
Prevention of pollution MARPOL 73/ 78
Transport & handling dangerous, hazardous cargoes
Maritime English
Proficiency in survival craft& rescue boats
Advanced fire-fighting
G.M.D.S.S. G.O.C.
Radar navigation, radar plotting, use of A.R.P.A.
Medical care
Ship Security Officer/Security Awareness

00009778
00009778
00003353

25.03.16
25.03.16
18.05.16

00006193
00004903

10.03.16
16.02.16

000017086

19.03.14

Nr.

Proficiency in fast rescue boats

Tanker familiarization
Specialization in oil tanker
Specialization in chemical tanker
Specialization in gas tanker
Bridge/Engine Team & Resource Management
Ships Handling & Manoeuvring
ECDIS
Bridge Simulator/Engine Room Simulator
ISM / ISO Course
Ro-Ro / Pass /Ferry

Date issued

FTK22597

15.11.13

00000506

22.01.16

Vaccination against yellow fever expire:

P R E V I O U S S E RV I C E - E X P E R I E N C E AT S E A
Vessels Name
HERCULES
AMIRA

Date:

11.10.16

Flag

Type

RO

TUG
BOAT
GENE
RAL
CARG
O

SIERR
A
LEONE

DWT/
GRT
3195 DWT

ME/ BHP

3394

1290KW

2X2726

Rank
ENGINE
CADET
ENGINE
CADET

Period
from to
02.01.14-03.03.14
30.05.15-22.10.15

Applicant signature:

Ships Managers and Crewing Agents

(include telephone number)
ARSOM
UNIMED NAVIGATION S.A