APLICATION FOR EMPLOYMENT

RECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

Rank / Ch.Officer/Master / First Name / Stijepo / Last Name / Dobud / Nationality / Croatian
Date & Place of Birth: / 09/09/1964 , Dubrovnik / Marital Status: / Maried
Present Address: / Trtni put 95, Viskovo / Next of Kin: / Gea Dobud,Wife
Home phone: / + 385 51 25 76 96 / Name / Relationship: / Gea dobud / Wife
cell phone: / + 385 92 106 24 29 / Address: / Trtni put 95, Viskovo
Fax:
Email: / Gea.dobud♠4ri.t-com.hr / Next of kin Cell Phone : / + 385 98 99 757 22
Father’s name / Tomo / Mother’s name: / Mirjana
Nearest Airport: / Zagreb / Km from Airport: / 145 / Present/Last Employer: / WSM, Norway
Languages: / English,Spanish,Portugese / Address:
Medical Certificate issued: / 05/03/2012 / Expired: / 05/03/2013
Any visa issued: / Expired: / Tel:
Weight(kg) / 90 / Height(cm) / 184 / Coverall Size: / 56 / Shoes Size: / 43 / Hair: / Brown / Eyes: / Blue
Position Applied: / Ch.officer / DP Operator / Date of availability: / 10/12/2012

Licence

Licence Country / Grade of Licence / Number / Place & Date Issued / Date Expired
Croatia / Ch.officer / 400134715 / Rijeka, 01/06/2011 / 01/06/2016
Norway / Ch.Officer / 120536 / Haugesund,03/05/2012 / 01/06/2016
Panama / Master / 88195 / Panama,14/10/2011 / 01/06/2016

Passports – If several passports write them all.

Number / Place Issued / Date Issued / Date Expired
193793713 / Rijeka / 14/07/2010 / 14/07/2020

Seaman’s Book - If several seaman’s books write them all(even if expired)

Country / Place Issued / Date Issued / Number / Date Expired
Croatia / Rijeka / 16/06/2011 / 00046463 / 16/06/2021

DP Log Book

Country / Place Issued / Date Issued / Number / Date Expired
UK / London / 30/03/2008 / 050005772

DP Certificates

Certificates / Place Issued / Date Issued / Number / Date Expired
DP Basic (induction) / Split / 28/03/02008 / DP0017
DP Advanced / Split / 30/12/2011 / DO0581
DP Limited
DP unlimited

Certificate

Certificates STCW / Date Issued / Place Issued / Expiration date / License Number
Yellow Fever certificate / 23/03/2012 / Rijeka / 03/2022
Helicopter Underwater Escape Training / 10/03/2012 / Split / 03/2015 / HUET-006/2012 Sp-I0200
Helicopter Landing Officer / 06/03/2012 / Split / 03/2015 / HLO-0101/2012SP-I 00202
MEDICAL III or II
ARPA / 01/06/2011 / Rijeka / 01/06/2016 / 400134716
GMDSS / 01/06/2011 / Rijeka / 01/06/2016 / 400134713
Advanced Fire Fighting / 27/05/20111 / Rijeka / 27/05/2016 / 400134653
Operator Certificate (CGO)
Operator Certificate (CRO)
PSCRB (BAERS)
Basic Safety TrainingCertificate(or Items from 1 to 4 below MANDATORY) / 27/05/20111 / Rijeka / 27/05/2016 / 400134650
1 - Personal Security and Social Responsibilities
2 - Personal Survival Technique / 27/05/20111 / Rijeka / 27/05/2016 / 400134648
3 - First Aid at sea / 27/05/20111 / Rijeka / 27/05/2016 / 400134652
4 - Fire fighting
BOSIET (STCW recognized) / 07/03/2012 / Split / 07/03/2017 / Bosiet 0101/2012SP-I00201

Application Form Page 1 of 5

APLICATION FOR EMPLOYMENT

RECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

Previous Sea Experience ( For Last 10 Years or Last 10 Ships Served )

Vessel’s Name / Flag / GRT / Vessel Type / Engine Type + KW / Company Name / Rank / Period: From / Period: To
Odin Explorer / Panama / 1544 / Seismic Research / V SHIPS / Ch. Officer / 24/10/2006 / 15/12/2006
Odin Explorer / Panama / 1544 / Seismic Research / V SHIPS / Ch. Officer / 13/02/2007 / 12/04/2007
Toisa Invincible / Bahamas / 2990 / PSV / SEALION / Ch. Officer / 04/07/2007 / 22/08/2007
Toisa Independent / UK / 3100 / PSV / SEALION / Ch. Officer / 22/08/2007 / 16/09/2007
Toisa Independent / UK / 3100 / PSV / SEALION / Ch. Officer / 15/10/2007 / 11/11/2007
Toisa Independent / UK / 3100 / PSV / SEALION / Ch. Officer / 12/12/2007 / 17/01/2008
Weza / St. Vincent / 2730 / AHTS / GREENMAR / Ch. Officer / 13/04/2008 / 19/06/2008
Malila / St. Vincent / 2730 / AHTS / GREENMAR / Ch. Officer / 19/06/2008 / 28/06/2008
Lim / St. Vincent / 8639 / M. Purpose / North A.Ltd. / Master / 15/07/2008 / 17/11/2008
Lim / St. Vincent / 8639 / M. Purpose / North A.Ltd. / Master / 07/12/2008 / 15/04/2009
Lim / St. Vincent / 8639 / M. Purpose / North A.Ltd. / Master / 22/06/2009 / 13/12/2009
Lim / St. Vincent / 8639 / M. Purpose / North A.Ltd. / Master / 08/02/2010 / 10/06/2010
Lim / St. Vincent / 8639 / M. Purpose / North A.Ltd. / Master / 09/09/2010 / 21/05/2011
Lim / St. Vincent / 8639 / M. Purpose / North A.Ltd. / Master / 09/09/2011 / 17/11/2011
Seisquest / Norway / 6262 / Seismic Research / WSM / Ch. Officer / 20/03/2012 / 29/05/2012
Seisquest / Norway / 6262 / Seismic Research / WSM / Ch. Officer / 23/06/2012 / 28/07/2012
Seisquest / Norway / 6262 / Seismic Research / WSM / Ch. Officer / 08/09/2012 / 07/11/2012
Artemis Arctic / Norway / 3947 / Seismic Research / OSM / Ch. Officer / 17/12/2012 / 17/01/2013
African Lifter / Cyprus / 9150 / Const./Accomodat. bar. / OSM / Master / 13/03/2013 / 24/04/2013

ANY ADDITIONNAL INFORMATIONS OR JOB DESCRIPTIONS /EXPERIENCES YOU WANT TO DETAIL IN PARTICULAR. WRITE HERE:

Detail the work you have done onboard previous vessels and your previous experience

Application Form Page 1 of 5