APPLICATION FORM FOR CONTRACTUAL EMPLOYMENT IN THE DREDGING

CORPORATION OF INDIA LIMITED, VISAKHAPATNAM.

FLOATING ESTABLISHMENT
 
Your Application
TME2019/2626/8/8/2019
acknowledgement Number :
 
Personal Details  :
Post Applied For Trainee Marine Eng.(On Contract)(Advt:01/2019)
Name of the Candidate AKSHAY MS
Date of Birth 03 Apr 1996
Age 23 yrs 3 m 29 d
Caste OBC
Nationality INDIA
Manjiparambil house, PO Naduvilkkara,
Address
Vadanappally, Thrissur, Kerala,680614
Landline
Mobile 9446804339
Alternate Mobile 7902604339
Email akshay.kohli18@gmail.com
Alternate Email
PAN Number / Aadhar Card
740669657173
No:
 
Professional Qualification  :
Valid
Issued
Name of the upto
Name of the Board / Institute / on
S.NO Document / dd/
University dd/ mm/
Certificate mm/
yyyy
yyyy
10th Class / S.S.C /
1 Bharath Vidya Mandir 21/5/2012 0/0/0
Matriculation
4 Yrs Degree in Marine Kunjali Marakkar School of Marine
2 Eng. from IMU Engg of Cochin University of 13/5/2019 0/0/0
Affiliated/DG Approved Science&Tech,Kochi
Professional  :
Name of the
Certificate Issued on Valid upto
S.NO Document /
No. dd/ mm/ yyyy dd/ mm/ yyyy
Certificate
1. CDC MUM 350450 17 Dec 2018 16 Dec 2028
2. INDOS 14EL3131
3. PASSPORT P6441615 26 Jan 2017 25 Jan 2027
4. STCW 95/2010  
 4.1 PST PST/EMA/1116-17/018217 01 Jul 2017  
4.2 PSSR PSSR/EMA/1154-17/019641 05 Jul 2017  
4.3 FPFF FPFF/EMA/1094-17/017600 15 Jul 2017  
4.4 STS STS/EMA/264-17/005370 07 Jul 2017  
4.5 EFA EFA/EMA/1179-17/018831 12 Jul 2017  
   

Fees Payment Details :  

Payment REF. Number:  DUB 8463193
Bank Name SBI
Branch Name Vadanapally (08683)
Date 07 Aug 2019
City THRISSUR
Amount 1000
 
Enclosures  :
SNo Certificate Attached Enclosed
1 10th Class / S.S.C / Matriculation Yes
2 4 Yrs Degree in Marine Eng. from IMU Affiliated/DG Approved Yes
3 CDC Yes
4 CASTE CERTIFICATE Yes
 
                The details furnished above are true and correct and in case any information
is found to be incorrect or false at any later stage, my candidature is liable to be
summarily rejected without any further intimation to me.
 
Place :
Date :   Thursday, August 8,
2019 Signature of the applicant