APPLICATION FORM  

Position
Position applied for ENGINE CADET

Readiness date 31/Aug/2023

Personal Details
Last name Aloyan First name Tom Gerald

Middle name Gender M

Date of birth 22/May/1999 Nationality Filipino

Place of birth San Carlos City Pangasinan

Country of Residence Philippines City of Residence Quezon City

Phone Mobile 09122952322

Zip code 1105 E-mail motaloyan@gmail.com

Address #47 Davao St Barangay Alicia Bago Bantay Quezon City Metro Manila

Identity Documents
Seaman book
Passport number P4651644C A0280289
number
Seaman book issue
Passport issue date 10/Jul/2023 23/Aug/2023
date
Seaman book expiry
Passport expiry date 09/Jul/2033 23/Aug/2033
date
Passport issue Seaman book issue
Philippines Philippines
country country
 Education
Type Name From year To year Qualification attained

College Pangasinan Merchant Marine Academy 2015 2018  

High school Saint Charles Academy      

Certificates
Issuing Place of
Category Certificate Number Issued Expiry
Authority issue
STCW
Basic Safety Training (STCW VI/1)   Philippines 08/Apr/2019 08/Apr/2024  
BASIC
STCW
Ship Security Awareness (STCW VI/6)   Philippines 11/Oct/2019 11/Oct/2030  
BASIC
STCW Basic Training for Oil tanker cargo operation (STCW A-
  Philippines 22/Aug/2023 22/Aug/2028  
BASIC V/1-1.1)
CBT Engineers watch keeping and night round   Philippines 27/Aug/2019 27/Aug/2029  

Licences

No record found

Visas
No record found

Vaccinations
Number Type Issued Expires Place of issue

  COVID-19 Booster 14/Aug/2023    

  POLIO VACCINE 24/Aug/2023    
  YELLOW FEVER 25/Jul/2023    

Special Skills
No record found

Sea Services
Owner /
 Owner /
Rank Joined Signed off Period Vessel Type Engine GRT DWT HP KW
Manager
1Y 0M M/V General Cargo Ship (with
EGT 02/Nov/2019 05/Nov/2020   759   2,060 1,536  
5D MYTHICAL 8 Ro-Ro facility)

Pre-Employment Checks
No record found

Experience
Vessel Type Period Voyages

EXPERIENCE BY VESSEL
General Cargo 1Y 0M 5D 1
Subtotal: 1Y 0M 5D 1

Total: 1Y 0M 5D 1

Rank Period Voyages

EXPERIENCE BY RANK
EGT 1Y 0M 5D 1
Subtotal: 1Y 0M 5D 1

Total: 1Y 0M 5D 1

Declaration
I hereby certify that the information given above is true and correct to the best of my knowledge and belief. That I have not withheld any
information that would affect my application unfavourably. 

Any false declaration, I supplied herein may constitute ground for disqualification and non-acceptance to the company and can be further subjected
to applicable penalties in accordance to existing laws governing the recruitment and employment of overseas seafarers.

Signature: Date:

________________________________ 01/Sep/2023
ENGINE CADET Aloyan, Tom Gerald