PO-To 1493 -C224-NOV.2014 1.8 Documentation Checklist Documentation Check List for Assessor Training On-Board course The following documents, duly completed, must be submitted to Seagull AS for evaluation and approval before Seagull AS can issue a Assessor Training diploma. 4. Candidate detail page completed confirming candidate's full name, date of birth, ‘addrose and nationality, ship's name, invoicing address etc, 2.Copy of ID of person who is signing the checklist (Mester or Assessor. 9.Copy of candidate's passport or discharge book confirming the full name and date of birth 4.Copy of test report from CBT # 263. ‘6 Copy of test report from CBT # 264. 6 Completed exercises from this workbook. 7.The Evaluator must complete the “Eveluaton of the Assessor Candidate’ form. All documents signed and verified by Master or Assessor ‘and marked with ship's stamp. 9. Documentation checklist completed and signed, A 40. Verification checklist for Assessor Training signed by Master/Assessor Thereby declare that this Is my own work and effort and that all is done according to procedure: 14 [Nov [2015 co Sie C Date Candidate signature IMPORTANT NOTE C oe Send the documentation by email to: obtraining@squill.coim— ew IF ANY OF THESE DOCUMENTS ARE MISSING, NOT READABLE OR OTHERWISE NOT COMPLETE, COURSE EVALUATION AND PROCESSING OF THE APPLICATION CANNOT BE PERFORMED EY SEAGULL AND THE APPLICATION WILL NOT BE APPROVED - www seagul. nout 1.9 Candidate detail page PO-TC -1495 -02/28-NOV.2014 First name SMITH Middle name = Tastname MIRANDA Date of birth (day, month, year) 03/04/1915 Nationality Po RTU GUESE Rankiposition CHIEF OFFICER Ships flag SLE Of MAN Shiprame Bw OPAL ‘Ship IMO number 9455662 Ship emai address Opal © bwflect cam Bw FLEET MaNAceMeNT PTE CD Name of Company ‘Company contact person = (Training dep.) TOAN Kwek ‘Company email address MANNING + SerP © BWM: cont Invoicing address ae - (Company) MAPLETREE BUSINESS CITY AENVG"O1 10 PASIR PANSANG ROAD SINGAPORE 115436 Note! For Norwegian seafarers and seafarers working on Norwegian flagged vessels who have boon issued a Norwegian D-numbor: Norwegian Social Security Number NA Na Norwegian D-number wo ng: ssseee Gee ho: Bai Stags We i ‘cat ine ee. vn 202500 wa seagul no052814813 cAPRUI CONSTANTA Colour of eyes Couleur des your Resigence Domicle 14 Domi 43. Culares ochior ROMANIA ROMANIA ROUMANIE ee Rou 052814613 “aac ROMANA ‘- ms ae Dreeree 1s CONSTANT PEROUSARPES>>>>>562095 1SEL1LOOZMBEDSOSZINAS>> HBCSLIN poppppna>poodd>>>d29>>29 0H LTMS>> VONVYTHIYd> d eer Ie, ezozseu sie st0z/10/10 ce wep Mg rarer ysanonidod peae eceee nee er VaNvuIW WiTWs 8 090205 Wnuk H3E NN Re eu mn mum anne VIGNI 3 ANANNEGAOO / MRIs bALls eos puna en ea sn pa f 4, Sioa Bathe wan 40 NBEO Efe irons yan e an) oneTraining Report: Principles of assessment Trainee name: 11851 Date: 6 November 2015, Total time used: 92 minutes. Chapter Completed Score ‘Terms and definitions 100 % Principles of assessment and assessment systems 100 % ‘Assessment using written test methods 100 % Assessment using direct observational methods 100 9% Assessment using oral questioning methods 100 % Validity and reliability of assessments 100 % Assessment 100 9% Score: 15 points out of 20 75% Total completed: 100 % 75% Print‘Training Report: Onboard assessment Trainee name: 11851 Date: 7 November 2015 ‘Total time used: 63 minutes. Chapter Completed ‘Score Principles of assessment 100 9% Preparing for an observational assessment 100 % Carrying out an observational assessment 100 % ral questioning ané listening techniques 100% Formulating oral questions 100% ‘Assessment 100% ‘Score: 16 points out of 20 80% Total completed 100 % 80% Print bear sea Besar ASR aWORK-BOOK 2 Exercises 2.4 Practical exercises - preparation The assessor candidate should complete and attach the following in preparation for the assessment of @ third party candidate: (20- marks/score) Q1. Produce a documented procedure for carrying out onboard assessment of competence The candidate assessor's planning should include: + Identification of the standards/criteria to be used for assessment _____+Reference to the assessment strategy if they ate assessing a qualification - The types and sufficiency of evidence required — evidence of performance in the work + How they will communicate with the leamer and others involved in the assessment process Loeatienaneieeeul quired for the assessment + Time and duration of the assessment + Specific learner needs and any supp support required + How-they-will 4hi + How they will record assessment processes and decisions How they will provide feedback to tearmer in addition this could be confirmed by witness Q2. Produce a feedback form for monitoring the assessment process Attached ________Q3. Select a relevant competence and produce detailed learning outcomes and learning objectives. Competence: To conduct safe cargo Operation from vessel CARGO CONTROL ROOM {A} KNOWLEDGE {8}- UNDERSTANDING (C) PROFICIENCIES (D) SAFETY —____ Cargo Watery Performance witty regard to 1)___ Safety of self, crew and vessel. 2) Proper and correct use of equipment 3) Knowledge of vessel and-cargo 4) Ability to understand and execute instructions. 5) Leadership 6) 7) Attitude and communication with shore personnel —_—8)— Ability to foltow-toading; discharging, de-ballasting and -ballasting-plans (Q4, Select a shipboard task that is suitable for assessing the chosen competence. Task:-In charge of Cargo operation whistle vessel in Port Q5. Produce an assessment specification for the chosen task including the necessary preparations for carrying out the assessment. Observation of performance in the work environment examining products of work + questioning the learner * discussing with the learner Page | 1WORK-BOOK * Use of others (witness testimony) = _____+ looking at learner statements —___ * recognizing prior learning Q6. Prepare supplementary oral questions for confirming the required knowledge and understanding associated with the task proficiencies. (A) Describe a time when you had to do similar cargo operation on your previous * What did you do? + What factors did you need to consider? What could you have done better to assist in the smooth implementation of the ‘operation? 7 + How would you rate the effectiveness of your operation on this occasion? (B) Can you tell me about a time when you missed to follow correct procedures? oD appeny + How were you responsible for this? * What did you do to try an overcome this problem? + What have you have done differently in relation to overcome this sutation? (C) Please tell me about a time when you have needed to construct and communicate a critically important plan to your seniors: + What was the specific situation? * What approach did you take and whom did you involve? *-How-did-you-communicate the-pian? + What feedback did you have in relation to its effectiveness? * What could you have done differently to improve your effectiveness? (D) Can you describe an occasion when you have needed to consider a number of possible scenarios when handling cargo operation? __+ What factors did you consider? _—_ oe + How did you select the correct course of action? * How did you minimize the risk of getting it wrong {E) Can you describe a time when you have needed to make a timely intervention + What prompted the decision and what did you do? + In hindsight, what could you have done differently? ~ How would you rate your effectiveness on that occasion? + How did you approach differ from that your colleagu h (F) Can you describe an-occasion when you have not been able to arrive ata mutually beneficial outcome? + Why? + What has been the impact of this? * What might you have done differently to have achieved a better outcome? es ar Estado Page | 2‘WORK-BOOK (G) Could you please give a recent example of when you have needed to explain — something difficult to someone who does not have your knowledge or background: + What information did you need to get across + What did you consider when constructing your message? + How effective were your efforts? How did you measure this? _______(I) Please tell me about a time when you have gono out of your way to assist a member of your team: + What prompted you to take action: and what diet your do? + What was the outcome’ * How has that changed things between you? (J) In your experience, have you ever observed others working in an unprofessionalunethical manner? + What was unprofessional or unethical about their behavior? + What did you specifically do about their behavior? + What were the implications of taking action? + Hew did you deal with the possible consequences? * How likely are you to take action compared with your colleagues? _______{K} Tell me about 2-time when you have been under a lot of pressure? — + To what extent were your colleagues and team aware of the stress you were under? * How did they know? phat -did-y + What was the outcome? + Why was frankness important? + How did you approach the situation? * What did you-say? “= How was your message received? Q7. Produce a scoring scheme for the assessment. Page | 3[THIRDOFFICER. WORK-BOOK °° °&°©&=~ © ©<& THIRD OFFICER - ____| Tobe filed by assessor by using the following grading system. A 2 3 4 5 |_Unsatistactory Below Satisfactory istaciory Good Excellent Grading 1 Reliability } 2 | Initiative __ —_ $$ - Sa ‘eam~—Wor 4 Ability to comprehend instructions & Ability to communicate concise and clear 6 Leadership qualities. 7 Analytica! abiltios 8 Discipline and conduct -|——9 safety consciousness t : 10 Ability to use English in written and oral form Overall Rating - The candidate has performed independent cargo handling watch to my satisfaction. With regard to: . Safety for himself, the ship's crew, and the vessel Proper anc correct use of the ships equipment + __ Knowledge of the vessel's cargo system including pumps, pipelines, Comments | invert gas systems. orders : Seamanship The-candidate ha: suitable. ee oe ==

Krovedse of ated ofertine reguromee ont emmy) g | glo lo repareeness K6romiodge, Abily & | + Knowedyeofret nous requeenents ao fojojo on + Good communication and reporting sits ofjojoja + _Protéeney and acurcyin paperwork ofofojo _Adeqate compe opening wedge anreaund oreusandwenia |g | glo | o databases Knowledge ad pocent ne ofalive ste We savaandeneners | |g] go ealnins + Mantis god eaanship win shomates ao lola|jo + _Sunmertivetowarsthe traning andoucence ofseesanstorimes | O |O| O | O ana spat a pa a fofojo + Demonstrates positive atitude and motivates others a oOo; a oO + Seeks feedback orinprovmentard aves te mpiove pertamance afofojo Teamcomosterces |, Vounars assistance and hat aproacveepprach oljajojo + Tekan pide inhib and ving optinaditonal fet weno | C | O] O | O + Tetesdrecon wot plans an exeutsin a tnely emer afofojo + Domonsratesconfence nis stone ake ondacontsrespomaiitvans | oy | | GQ) can work wah minal supervision + Consutnmatinarsenssi msprisesonsineverwinences | || gg ‘company standards pottia 2008 Page tof fo ¢ lane gee BEF Hopes - ee MtEEs ar ze $US Ene. Pores aaabuKWORK-BOOK 22 Practical exercises -assessment The assessor candidate should complete and attach the following prior to, and.as part of, the assessment ‘of the third party candidate. (20 marks/score) Al. Carry out a pre-assessment briefing explaining the assessment specification and performance _____“requirements for demonstrating competence | Exact Assessment requirement: - Specific learning Objectives ‘How the results and any associated data may be used and stored | Method of assessment | Details of any appeal procedures \@2. Observe and carry out an assessment of the third party candidates performance ZSJOFFICER | PROFIENCY IN CARGO OPERATION 3. Use oral questioning to confirm knowledge requirements ORAL QUESTIONING CARRIEDOT AS PER TASK Qs, Provide initial feedback and document the results of the assessment Recon ATTACHED 25. Carry out a post assessment debrief and provide detailed feedback REGED ATTACHED G8. Produce a performance improvement plan based on the result of the assessment if where outcomes are nor met. REcoRD ATTAWED —<—a hao | fo aE see ses Na cof Bene en rove 828WwORK- BOOK QA Ship's Statt Competency Feed back ame of Employee Vosse! Bw OPAC rank sre omer Revowore Name | MIRANDA QuiiTih I Rank | Ghiet-Otficer_ to of Appraisal Bl Nev] is “enue onboerd From: N9IEPIS | ro: 13 [Now tS summary: Deck watch keoping officer with delegated responsibilty for safety epoiances PERFORMANCE {-Poar Knowledge | 2=Some Improvement | 3-On Expectation | 4 ~ Above | aa Visi ifec® T compra min aksatty rd ontornonil creates areauotors on oy | | a | | toe 1+ Maintaining ecient and relate cargo wate inthe CCR. o jojo | + Conducting rade communicator dues (duieg operations) o jol|eo respraitin [+ Waning We sa ow Be ening ewenen as er omery| of | Q| a] O sooui <—Praieg, nontaing and reandeg genera manerance of ee! 1) || a | O quent are wie nsrunenis 2 oguimd iia tho PNS + staring cneg watches npr o jole|o ‘+ Assisting in maintaining seavorniness of vos! a jojejo TTruedgr of Saleh) Managenedt Sytem ard comeaiences eatabion | | oy | “| O STOW requiemerts | TT Knmmiedge of enicsl eparaiors egaremens ana ener] |) | O prepares : | owwdge, Abiny & | = _ Krowldgo of retour equiemants o foje|o| si = Good communiation ad reporting sis olo|r|o + Profelency and azcuracyn paperwak ao jol@ia T Adequate computer opereg nomedge srequmsterruserawenig | oy | | GY| O pie = Knowledge and profcient use ofa re, safer, Ife seving end emergency alo wlio TT | Maitsins good retaonstin wi shimates o jol|er|o + uppowe varisihe ving magus pees andsibariraes | 1 | O | O we + Parone ststons supervision a appreniate ao lwlo|a + Demansiraies positve atitude and metivates others o joleo Gocks leodack forimprovan’ and stivs to nprove perfomance ofjoly|o ‘Team Compstonsie |. yourteers assistance and nasa poasive sepro2c ojol|e|o + Tates pide inhis jab and & witing to pun adliional effort ae required o jo}e|a + Taker rection wal, slans and execuesina timely manner o jo|le|o ——Dermanctstes conten nie acors wher and accepts esponsbityane | | | | O ean work wih nin supervision Ls | Fe aends hinaetnapesiatleand poksimnamamewanrern'sts | oy |) | O company standart - [Komal rectiia 2008 Page 1 oftWORK- Book QS, Carry out a post assessment debrief and provide detailed feedback “Technical Knowledge ‘Assessment ‘Comments WDD [OD [NE - Academie Qualifications: University degree, preferably advanced university degree or equivalent background, in Nautical Studies vi || B. Experience (Please select one below) ‘Two years of relevant professional work experience. Moge Tiny 2 Yes PloFecctoone BD) . Specialized Expertise Worken @RIEFey LeITH DiFFeRENT| ‘Knowledge of seamanship and safety. ea {Understanding of relations with ship mates RaTioUALITE S D, Languages Seas teen Teeny Baelih v AS KequeD, MARITIME InWeTRy Foundational Competaneiag Sawn | STRONG CommITMENT TowAnn prslonataly nd enthasastialy demon GMa comet Theron responsibility and dedication. Aligns one’s a conduct with goals, ideals and guiding Leese nicest RiamaNatou principles. Commits to building a culture that Bean 4 MAKING A DIFFERENCE embodies these ideas a RENCE *Drivefor Results Peover Reco OF GETTING THANG) Effectively translates ideas ito actions, Has a _ DONE EFFECTIVELY drive to implement goals and objectives, to accomplish tasks, ensuring the end-results [Seven OF Ws iDeas Aas smnDAeD FoR cARGro opeRAnION, + Embracing Diversity ‘Values differences in gender, culture, opinions, values, perspectives, ideas, skills, and experiences, v WORKED ON VARou sype OF si wim a VeRteTy oF FeorLe integrity ‘Acts with uncompromising ethics and honesty at all times, in all situations, both professionally and personally + Self Awareness and Self-Regulation Knowing and managing one's own emotions, sirengths, weaknesses, passions, interests, and values, + Teamwork Cooperates and works effectively with others in the pursuit of common goals. AWARE OF MIS OLON STRENGTHS Tae aaa DAES | bcovancu'r ca neve. NEVER Lotion ATW? TNogeanDeTE, Functional Competen: ‘Analytical and Conceptual Thinking Solves problems based on the critical review of facts, data, and information and draws conclusions based on logical reasoning. KHAVE UNDE REA — OMG, RNOCLEDE JOF TECHN L ISSUES: RE WET IN SAMING PROBLEMS BULKKELY AnD eFFeaiveLy Tafluence Influences attitudes and opinions of others and gain agreement to proposals, plans and ideas. FOQLE ON OWN SELUTIONS , DOES WoT ASK FoR OTHERS OPINIONS Professional Knoviledge/ Leadership Exercises relevant expertise or utilizes knowledge of a technical nature that requires specific training, experience, and education Preftxy TO coon AONE, OR BE Gwent CLEAR BusTeVerons WD - well developed, D — developed, OD — opportunity for. een ‘NE - no evidence obtained S_ War BW OFAC Matas Shae a Bag 0 yo: tee Ph: rason 15 71598 ENG, PR 28000 yzWORK Bools ‘Comments and Recommendations: I RELIARLE CANDIDATE LOITH A RELEVANT BACKGROVND I— HE fEemy TO BE A BIT NERVOUS, BvT HANDLED QUESTION, Professronacy — STRONG COMMITMENT YOWAEDS MELO LEARNING TS ANTRESTED IN USING HID PREVIOUS EXPOUENCE CAN BE Consipereo “TO HAUDLE CARGO OPERATIONS INDEPENDANTELY ANID UNDER SUPERIVISION Learning/Developmental Needs: NH youn BE BENEFICAL fof HIMG To ATTEND : ablro TRAINING Jy LIQUID HANDLING SumIcaToR Mikavoa smertt hiv act MEP. OF cee Name/ Rank of Candidate Date and Signature INTERVIEVER, MH ov IS, chee exe rnWORK- Book: Performance Improverne | Ship Bw oPAL Candidate Name Bo Aol Bor PER STCW function area | OPE WATIONA Wo Competence/ Proficiency ‘Assessment result ‘Areas forimprovement Recommended action Peformance, recedures or tasks, equipment. cessessment process) (Adstioneltahina, evse procedures or tass,chonge eaulpment, revise exsessmentprocess) A) Banpeina @F CAoee pumrs [> EBT (TAKER openarion) Bi CARE CALCULATION Le 684 Oi gyKeR TRAINING System ® Staewiry > Tame /ssasiury @orkiere ¢ MIN BW OFPIcEe Foe WS KHOMICEDCE BD Peped TE PAH WHICH 2EQ LINED [trove Zur] ASSEN WAS Gop? TWESL 7S Aageus NEW tee eR Omen ce Foe Che bo WATCHES. eae Vesselname: _ Buy OPAL Date: is/) APs Zz Miapmectie” Evaluator’ (sign): // al io ee SB = Sei tags Wat ozs mad co BIS #88, Bato * Evaluator = Qualified Assessor (or MasteriChief Engineer if no Qualified Assessor is onboard) 12 ww seagull 00PC-TC -1498 ~07/24-NOV.2014 41.10 Verification checklist for Assessor Training To ensure that Seagull on board courses are done according to our procedures, all documents and ‘checklists must be signed and stamped. This shall be done by Master or a qualified onboard ASS2SS0F, Hfnot stated in the workbook, the Mastor/Assassor does not have to check if all answers are correct. This will be done by Seegull AS. If Seagull AS finds that an application 's partialy or entrely a duplicate of another application, the application will be rejected and certificate will nat be issued, The candidate and company will be notified ‘The MasteriAssessor must take all necessary precautions to ensure that all these requirements are met. ‘The MasteriAssessor is jointly responsible that the applications are according to our procedures end guidelines. in the STCW Convention, regulation \/6 and section A-1/6 it's required that all training land assessment of seafarers are administered, supervised and monitored. ‘The Master/Assessor is part of fulfng this requirement. By signing this document | confirm that the following items are completed and verifie: Candidate's ID and personel details are correct ‘The CBTs are et least 95% completed and the candidate has achieved an assessment a score of at least 75%, ‘The workbook (questions and exercises) is completed ‘The CBT modules (#263,4264) and worktook are individual and unaided work of the partici Signing es Assessor on course applications which is a copy of another application 's document [[}-~ fraud. SS x phufzers,_ _—_ Date | nature of Mastef*/Assessor ‘ifthe Master is the candidate, another Senior Officer must be responsible that the on board traini has been done according course procedure. Master/Assessor details. First and middie name ARPS OAHU Lastname 242 VAN : Date of birth 02/07/1935 Rank th 4s7eR ° wn seagull no: