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CURRICULUM VITAE Application Form

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Revy Aurliya Adistya

Academic year: 2023

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CURRICULUM VITAE Application Form

Section 1 POSITION APPLIED

Position Applied for Deck Cadet Lowest Position Acceptable -

Date of Availability -

Section 2 PERSONAL DETAILS

Family Name/Surname JALU

First Name/Given Name JALU ROMADHON

Date & Placeof Birth NOVEMBER, 28th 2000 PLACE – CILACAP

Gender MALE

Martial Status SINGLE

Religion MOSLEM

Nationality INDONESIAN

Permanent Address JL. GERILYA RT 01 RW 12 – DESA KARANGTENGAH – KECAMATAN SAMPANG KABUPATEN CILACAP – JAWA TENGAH OF INDONESIA

PPE INFORMATION Safety Shoes Size 43 Over all Size Large

Blood Group Type = O RH = +

Physical Information Height 178 cm Weight 60 kg

Present Contact Number +6288239004846 (WA) E-Mail Address [email protected]

Nearest Airport (and Distance) AHMAD YANI INTERNATIONAL AIRPORT OF SEMARANG – INDONESIA

Section 3 PASSPORT AND VISA DETAILS Period Of Semester Poin GTA

Country of Issue REPUBLIC OF INDONESIA Semester 1st 3.14

Date Issued AUGUST, 31th 2022 Semester 2nd 3.27 3.23

Place Isuued CILACAP Semester 3rd 3.25

Passport Number E0350288

Semester 4th 3.26

Section 4 SEAMAN BOOK /DISCHARGE BOOK /SEAMAN RECORD BOOK

Issuing Country & Place REPUBLIC OF INDONESIA/CIREBON

Number H099217

Section 5 NEXT OF KIND

Full Name/Relationship KUKUH DARMAWAN/YOUNG BROTHER

Address JL. GERILYA RT 01 RW 12 – DESA KARANGTENGAH – KECAMATAN SAMPANG

KABUPATEN CILACAP – JAWA TENGAH OF INDONESIA

Contact Numbers +6281215216870

Section 6 STCW 2010 9 STCW 7 8, AS AMENDED) RELATED COURSES ATTENDED AND CERTIFICATES OBTAINED Name of Course/Certificate STCW Code Place of Issue Issue Date Certificate

Number Expiry Date Seafarer With Designated Security

(SDSD) A-VI/6 PIP Semarang July 27th 2022 6211715412

320321

July 28th 2026 Basic Training for Oil and Chemical

Tanker Cargo Operations (BTOCT)

A-V/1-1-1 PIP Semarang June 14th 2022 6211715412

390321 June 19th 2026 Medical First Aid (MFA) A-VI/4.1-3 PIP Semarang June 23th 2021 6211716412

070321 June 25th 2026 ARPA Simulator A-II/1.5,A-II/2.2 UNIMAR“AMNI”SMG Dec 30th 2020 6211715412

021220 Nov 28th 2025 RADAR Simulator A-II/1.5,A-II/2.2 UNIMAR“AMNI”SMG Dec 30th 2020 6211715412

031220 Nov 28th 2025 Adfanced Fire Fighting (AFF)

Revalidation A-VI/3 PIP Semarang Dec 05th 2022 6211715412

060371 Dec 05th 2027 Security Awareness Training (SAT) A-VI/6 PIP Semarang March 23th 2022 6211715412

310317 Unlimited

Basic Safety Training (BST)

Revalidation A-VI/1 PIP Semarang March 22th 2021 6211715412

010321 March 22th 2026 ADDITIONAL CERTIFICATE

Name of Course/Certificate Place of Issue Issue Date Registeration Number Expiry Date Bridge Simulator UNIMAR"AMNI"SMG July 01th 2021 694/UNIMAR"AMNI"/BS-VII/2021 Unlimited Port State Control UNIMAR"AMNI"SMG Feb 22th 2021 1644/UNIMAR"AMNI"/SO/TC/2021 Unlimited International Safety Management (ISM) Code UNIMAR"AMNI"SMG Feb 22th 2021 3726/UNIMAR"AMNI"/SO/TC/2021 Unlimited Leadership and Teamworking Skill

(STCW 2010 Tbale A-II/I, A-III/I and AIII/6) UNIMAR"AMNI"SMG Feb 22th 2021 1953/UNIMAR"AMNI"/SO/TC/2021 Unlimited Marine Pollution and Environmental Awareness

(IMO Model Course 1.38) UNIMAR"AMNI"SMG Feb 22th 2021 1237/UNIMAR"AMNI"/SO/TC/ 2021 Unlimited

Your Faithfully, Jalu Romadhon

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