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JOB APLICATION FORM

My complete data are so follow :


Full name : Serfasius Agut
Rank : A/B
Place/date of birth : Nul,09-September-1988
Sex : Male
Religion : Katholik
Address : Komp.DPR GG. IV No Banjarmasin
Phone : 082187771279

TRAVEL DOCUMENT
NO Name of Document Licence No Date of Issued Date of Ex
1 Scaman Book W 011810 01/01/09 05/01/12
2 Pasport T 977348 06/10/09 06/10/14

CERTIVICATE OF COMPETENCY
NO Certivicate name Certivicate number Place Date of Issued
1 Dect Watckeeping 6200490072N60609 22/04/09

CERTIVICATE OF PROFICIENCY
NO Certivicate Home Certivicate number Date of Issued
1 Basic Safety Training 6.20E+15 03/10/08
2 Survival Craft and Rescue Boat 6.20E+15 01/11/08

WORKING EXPERIENCES
NO Vasel Home Type Of Rank GRT HP Company
1 MV.Pelita Luna Cargo A/B 2645 1000 Lunas Clipping
2 TB.Kencana Raya Tugboat A/B 124.05 1310 SDN - BND

Faith Fully

Serfasius Agut

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