MOTIA COMPAGNIA DI NAVIGAZIONE SPA
Mot/P/24
CURRICULUM VITAE OF OFFICER
Last Name* :
Given Names* :
Key No :
Date of Birth* :
Pick Date
Birth Place* :
Nationality* :
Present Rank* :
Date Joined* :
Pick Date
Rank Joined* :
Dry Cargo : Chemical : Oil Tanker :
Indos No :
Last Physical Exam Date :
Yellow Fever valid Upto :
Pick Date
US Visa
Valid Upto :
Pick Date
Address* :
Phone* :
E-mail* :
Next of Kin :
Relationship :
Certificates
Documents
 
Indian
Liberian
Seaman Book
Liberian ID
Passport
 Grade :
 Number :
 Placed Issued :
 Date Issued :
Pick Date
Pick Date
Pick Date
Pick Date
Pick Date
 Expiry Date :
Pick Date
Pick Date
Pick Date
Pick Date
STCW
No.
Certificate
Number
Issued
Expiry
No.
Certificate
Number
Issued
Expiry
1.
Pick Date
14.
Pick Date
2.
Pick Date
15.
Pick Date
3.
Pick Date
16.
Pick Date
4.
Pick Date
17.
Pick Date
5.
Pick Date
18.
Pick Date
6.
Pick Date
19.
Pick Date
7.
Pick Date
20.
Pick Date
8.
Pick Date
21.
Pick Date
9.
Pick Date
22.
Pick Date
10.
Pick Date
23.
Pick Date
11.
Pick Date
24.
Pick Date
12.
Pick Date
25.
Pick Date
13.
Pick Date
26.
Pick Date
LIBERIAN SPECIAL QUALIFICATIONS
No.
Certificate
Number
Issued
Expiry
No.
Certificate
Number
Issued
Expiry
1.
Pick Date
7.
Pick Date
2.
Pick Date
8.
Pick Date
3.
Pick Date
9.
Pick Date
4.
Pick Date
10.
Pick Date
5.
Pick Date
11.
Pick Date
6.
Pick Date
12.
Pick Date
RECORD OF SEA SERVICE
Last Name :
Other Names :
Key No :
Present Rank :
Name Of Pre Sea Training Establishment :
No.
   Ship's Name
   Company's Name
Year
Built
   Ship Type *
   Engine Maker *
DWT
Power
RANK
FROM
TO
1.
Pick Date
Pick Date
2.
Pick Date
Pick Date
3.
Pick Date
Pick Date
4.
Pick Date
Pick Date
5.
Pick Date
Pick Date
6.
Pick Date
Pick Date
7.
Pick Date
Pick Date
8.
Pick Date
Pick Date
9.
Pick Date
Pick Date
10.
Pick Date
Pick Date
11.
Pick Date
Pick Date
12.
Pick Date
Pick Date
13.
Pick Date
Pick Date
14.
Pick Date
Pick Date
15.
Pick Date
Pick Date
16.
Pick Date
Pick Date
17.
Pick Date
Pick Date
18.
Pick Date
Pick Date
19.
Pick Date
Pick Date
20.
Pick Date
Pick Date
21.
Pick Date
Pick Date
*
Deck personnel - Indicate only “Type of Ship”. Engine personnel must indicate both (Type of ship and Engine maker)
*
Records must be entered in descending order, i.e., most recent record should be at the top of the list.