The document is an application form for a deck officer position, detailing the personal information, qualifications, and previous sea service of the applicant, Shady Siam, a Sudanese national. It lists his educational background, certifications, and professional experience, particularly in roles related to cable ships. Contact information and a request for salary are also included, indicating his qualifications align with the position sought.

1. APPLICATION FORM - DECK OFFICER CREW
Personal Details
Rank: MASTER / 1st Mate / 2nd Mate DPO Nationality: SUDANESE
First Name: SHADY Surname: SIAM
Father’s Name: OMER Mother’s name LAILA
Date of birth: 01/01/1984 Place of birth: CAIRO
Telephone: +971556605193 Requested Salary: 8200 $
Mobile Phone: +971556605193 Nearest Airport: DUBAI INTERNATIONAL AIR PORT
E-mail: SHADYSYAM@GMAIL.COM Shoes size: 40
Skype Address: SHADYSIAM@SKYPE.COM Overall size: MEDIUM
Home Address: AL JURF 2, AJMAN, UAE
Next of Kin
Surname: SIAM Name: RAMY
Relationship: BROTHER Telephone: +249912310801
Home Address: AIRPORT VILLAGE SQUAER 3, PORT SUDAN-SUDAN (SPC)
Travel Documents Number Place of Issue Issued on Expires on
National Passport: P 04905761 Dubai 09/08/2018 08/08/2023
Seaman’s Book: 12945 Port Sudan 16/10/2019 15/10/2025
UAE Visa: 25763652 UAE 19/06/2018 18/06/2021
UAE Driving License 544102 UAE 19/08/2013 18/08/2023
Education / Qualifications
Place of issue
Date of
issue
Bachelor’s Degree in Maritime Transport - Nautical Technology - AAST - Alexandria Egypt 5/25/2008
Master Mariner - AAST -Alexandria Egypt 14/11/2017
STCW Certificates Number Place
of
Issue
Issued on Expires on
COC - Specified to rank and flag of vessel 6571 Egypt 15.11.2017 25.07.2022
Navigation RADAR & ARPA Simulator and SR 28042/17/EG Egypt 07.08.2017 N/A
Bridge Resources Management (BRM) 33724/17/EG Egypt 27.09.2017 N/A
Ship Handling and Maneuvering 27877/17/EG Egypt 03.08.2017 N/A
ECDIS Simulator (Operational Level) 28046/17/EG Egypt 07.08.2017 N/A
Marine Radar and automatic Radar plotting Aids 28044/17/EG Egypt 07.08.2017 N/A
Advanced Communications 28045/17/EG Egypt 07.08.2017 N/A
Prevention & Combating of marine pollution 28043/17/EG Egypt 07.08.2017 N/A
GMDSS (Global Maritime Distress Safety System) 29655/17/EG Egypt 16.08.2017 09.08.2022
STCW Proficiency in Medical Care 28043/17/EG Egypt 02.08.2017 31.07.2022
STCW Designated Security Duties training 29017/17/EG Egypt 10.08.2017 06.08.2022
STCW Advanced Fire Fighting 26774/17/EG Egypt 26.07.2017 24.07.2022
Proficiency in Survival Craft and Rescue Boats 26746/17/EG Egypt 26.07.2017 24.07.2022
Personal Survival Techniques 27194/17/EG Egypt 30.07.2017 26.07.2022
Personal Safety and Social Responsibilities 27271/17/EG Egypt 30.07.2017 26.07.2022
Proficiency As A ship security Officer (PSSO) 28869/17/EG Egypt 10.08.2017 09.08.2022
ECDIS Advanced Simulator (Management Level) 27967/17/EG Egypt 06.08.2017 02.08.2022
T-BOSIET OPITO 2835550108111600773 UAE 08.11.2016 07.11.2020
Basic H2S Training 2835901408111600797 UAE 08.11.2016 07.11.2018
UAE COC Endorsement Master II/2 22039039080419 UAE 16.04.2019 25.07.2022
License(s) Held Number Limitation(s) on GRT (if any) Grade/Class of license
1ST MATE NAV. 4465 NONE II/2
MASTER 6571 NONE II/2
Photo

2. UAE GOC Endorsement IV/2 35133835111218 UAE 27.12.2018 09.08.2022
FTA Sea ID Card 55009438230120 UAE 26.01.2020 25.01.2021
Emirates ID 784-1984-4204130-1 UAE 17.06.2018 18.06.2021
Special Training Certificates Number Place of
Issue
Issued on Expires on
DP Induction/Basic course 30151/17/EG Egypt 20.08.2017 15.08.2021
DP Advanced/Simulator course N/A UAE 01.11.2012 31.10.2017
Old Offshore Scheme NI logbook Blu - 31755 UAE 03.09.2009 N/A
ECDIS Type Specific Training Course (Danelec Marine) DM-DM8-0084 UAE 10.09.2015 N/A
Medical Certificates Number Place of Issue Issued on Expires on
Medical Fitness Certificate 54655 Egypt 03.12.2017 02.12.2019
Yellow Fever Vaccination 5225-2 UAE 05.12.2013 04.12.2023
Previous Sea Service
# From To Vessel Flag GRT/HP Type Position Company
1
02/01/2020 01/06/2020 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
2
29/03/2019 18/10/2019 Niwa UAE 13201/12900
Cable Ship
DP2
Master - DPO
E-marine -
PJSC
3
15/11/2018 01/02/2019 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
4
06/11/2018 15/11/2018 Niwa UAE 13201/12900
Cable Ship
DP2
Master - DPO
E-marine -
PJSC
5
01/11/2018 06/11/2018 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
6
26/03/2018 03/09/2018 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
7
31/10/2017 14/02/2018 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
8
14/09/2016 03/04/2017 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
9
03/09/2016 31/7/2016 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
10
03/11/2015 03/02/2016 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
11
06/06/2015 21/09/2015 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
12
20/21/2014 29/03/2015 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
13
11/08/2014 11/11/2014
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
Ch. Mate DPO
E-marine -
PJSC
14
26/02/2014 30/06/2014 Niwa UAE 13201/12900
Cable Ship
DP2
Ch. Mate DPO
E-marine -
PJSC
15
09/10/2013 21/01/2014
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
Ch. Mate DPO
E-marine -
PJSC
16
09/06/2013 21/09/2013
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
Ch. Mate DPO
E-marine -
PJSC
17
01/01/2013 01/04/2013
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
Ch. Mate DPO
E-marine -
PJSC
18
08/08/2012 31/12/2012
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
2nd Mate DPO
E-marine -
PJSC
19
14/06/2011 09/07/2011 Etisalat UAE 2221/1850
Cable Ship
DP1
3rd Mate DPO
E-marine -
PJSC
20
09/01/2011 13/06/2011 Niwa UAE 13201/12900
Cable Ship
DP2
3rd Mate DPO
E-marine -
PJSC

3. 21
01/04/2010 25/11/2010
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
3rd Mate DPO
E-marine -
PJSC
22
2708/2009 01/03/2010
Umm Al
Anber
UAE 7750/8000
Cable Ship
DP1
3rd Mate DPO
E-marine -
PJSC
23
19/03/2009 25/08/2009 Adriatica Panama 19009/9600
Passenger
Ferry/RoRo
2nd Mate
Aljoudy
Maritime
24
18/08/2008 18/02/2009
M.T
Beilul
Eritrean 2025/2000 Tanker 2nd Mate
Eritrean
Shipping
25
08/01/2005 31/07/2006 Aida IV Egypt 3105/1500
Training
Ship /SPV
Cadet AAST
Reference available upon request
Thank you. I hope my qualification match your need
Updated on 15.06.2020