INSERT

JUAN P. DELA CRUZ

2X2 DECK CADET
PICTURE To be able to enhance my knowledge on board the vessel and to experience
working with others as a team and as an individual and sharing my knowledge
with others in return.

PERSONAL DATA
SURNAME DELA CRUZ
FIRST NAME JUAN
MIDDLE NAME PILAR
DATE OF BIRTH DECEMBER 25 1996
AGE 26 YEARS OLD
GENDER MALE
CIVIL STATUS
RELIGION
NATIONALITY
HOME ADDRESS
PRESENT ADDRESS
EMAIL ADRESS
CONTACT NUMBER

EDUCATIONAL BACKGRO
NAME OF SCHOOL
TERTIARY PMMA
SECONDARY
PRIMARY

SEA SERVICE RECORD

RANK COMPANY / SHIP NAME TYPE OF VESSEL GRT
 CERTIFICATE OF PROFICIENCY (C
NAME OF CERTIFICATE CERT. NUMBER
BASIC TRAINING 0987654
SSAT/SDSD
MEFA

TRAVEL DOCUMENTS
NAME OF DOCUMENTS NUMBER
PHILIPINE PASSPORT
SID
SEAMAN'S BOOK
YELLOW FEVER
POLIO
US VISA

CHARACTER REFERENCE
NAME POSITION

I do hereby declare that the particulars of information and facts stated here are true and com
to the best of my knowledge and belief.

JUA
APPLICA
the vessel and to experience
ual and sharing my knowledge

RSONAL DATA
SSS NUMBER
TIN NUMBER
PAG-IBIG NUMBER
PHIL-HEALTH NUMBER
U-MID NUMBER
E-REG NUMBER
SRN NUMBER (POEA)
MARINA ID NUMBER
EYE COLOR BROWN
HAIR COLOR BLACK
HEIGHT
WEIGHT (KG)
BLOOD TYPE O

ONAL BACKGROUND
L COURSE SCHOOL YEAR
BS IN MARINE TRANSPORTATION 2018 - 2021

ERVICE RECORDS
GRT HOMEPORT JOINED SIGNED OFF PERIOD
PROFICIENCY (COP)
SERIAL NUMBER DATE ISSUED EXPIRED DATE
098765 DECEMBER 25 2022 DECEMBER 25 2027

EL DOCUMENTS
ISSUED BY DATE ISSUED EXPIRED DATE

TER REFERENCE
POSITION CONTACT NUMBER

ated here are true and complete

JUAN P. DELA CRUZ

APPLICANT'S NAME & SIGNATURE