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CHECKLIST
APPLICATION FOR LETTER OF ELIGIBILITY
MASTER & CHIEF MATE ON SHIP OF 3000 GT OR MORE (U.V) (A1MC)

1. Name of student : RAEQ FAIROOZ

2. Nationality : BANGLADESHI

3. Date of Birth : 14/08/1992

4. Passport No : A01806631

5. Email Address : raeq109@gmail.com

6. Address : FLAT: 2C, HOUSE: 189; ROAD: 02; MIRPUR DOHS; DHAKA-1216

BANGLADESH.

7. Particulars of Students Submission

No. Document/Particulars Submitted Yes No Remarks

a. Hold a Certificate of Deck Officer Class: COC NO : BD10031326

i. I COC Verification Link:

ii. II http://verification.dos.gov.b
iii. III YES d/search/web/coc.html

b. Modular Course Certificates YES FOR ALL GMDSS Verification Link:

i. GMDSS-1652/15
http://verification.dos.gov.b
i. GMDSS - GOC d/search/web/coc.html
ii. Proficiency in Survival Craft ii.BDPSCRB-000570
iii. Advanced Fire Fighting iii. BDAFF-000474
iv. Medical First Aid iv.BDMFA-000207 COP Verification Link:
http://verification.dos.gov.
v. ARPA v. 051.114751
bd/search/web/cop.html
vi. Radar Navigation vi. 051.114751

AKADEMI LAUT MALAYSIA Mailing Address:

Window Delivery 2051 Batu 30, Tanjung Dahan T : +6 06 3882 200
Masjid Tanah Post Office 78200 Kuala Sungai Baru F : +6 06 3876 700
78300 Masjid Tanah Melaka, MALAYSIA E: mma@alam.edu.my
Melaka, MALAYSIA http;//www.alam.edu.my
 c. Discharge Book

Vessel Rank Sign On Sign Off Month / Day

NAZIA JAHAN 2ND OFFICER 11.09.2020 18.08.2021 11 / 07
NAZIA JAHAN 3RD OFFICER 29.11.2018 25.04.2019 04 / 27
ABDULLAH 3RD OFFICER 04.11.2017 24.03.2018 04 / 20
ABDULLAH 3RD OFFICER 08.09.2016 12.04.2017 07 / 04
/
/
/
/
/
TOTAL SEA SERVICE 3 27 / 28
1
/
No. Document/Particulars Submitted Yes No Remarks

d. Testimonial from Companies:

•Very Good
•Satisfactory
YES
•Excellent

e. Authenticity: COC & GMDSS Verification Link:

http://verification.dos.gov.bd/search/
•COC YES web/coc.html
•Seaman card YES CDC Verification Link:
http://erp.gso.gov.bd/cdc-search
•Discharge Book YES
•Certificate COP Verification Link:
YES http://verification.dos.gov.bd/search/
* Check, confirm and true. web/cop.html

Comments:

Capt. Dr. Kumaresan.S.

Master Mariner, MSc (UK), PhD (UK), AFNI
Head of Advanced Nautical Studies Department
MALAYSIAN MARITIME ACADEMY (ALAM) Date:

AKADEMI LAUT MALAYSIA Mailing Address:

Window Delivery 2051 Batu 30, Tanjung Dahan T : +6 06 3882 200
Masjid Tanah Post Office 78200 Kuala Sungai Baru F : +6 06 3876 700
78300 Masjid Tanah Melaka, MALAYSIA E: mma@alam.edu.my
Melaka, MALAYSIA http;//www.alam.edu.my