03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

CREW PERSONAL DETAILS

POSITION APPLIED FOR : Chief Engr.

FAMILY NAME : BELLOSILLO

NATIONALITY: FILIPINO

AIRPORT: MANILA

DATE OF BIRTH :
17/Aug/1970 Age 54 yrs
(dd-mmm-yy)

FULL ADDRESS: BLK.2, LOT 6 VIST RIVA SU

MOST CONTACTABLE NOS. :

9563693935
(HP / LANDLINE)

PASSPORT AND SEAMAN'S DETAILS:

PASSPORT NO. : P2174306B

US VISA EXPIRY DATE

(dd-mmm-yy)

SEAMAN'S DISCHARGE
C1142219
BOOK NO. :

NEXT OF KIN DETAILS

NAME OF NEXT OF KIN :

IMME MAYOR BELLOSILLO
(NOK)
NOK CONTACT NO:
9193782862
(HP / LANDLINE)

NOK EMAIL ID :

MEDICAL HISTORY

LAST DATE OF MEDICAL

CHECKUP: (dd-mmm-yy)

03+000Prepared by: HSE Department Approved by: 1CEO 03+000Rev. 04 July 2023
03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

ANY PHYSICAL DISABILITY:

NO
(if yes, please specify)

ANY MAJOR ILLNESS / HEALTH CONDITION / SURGERY / ACCIDENT : NO / YES (if yes, please specify

NO

ANY PRESCRIBED MEDICATION / LONG TERM MEDICATION BEING TAKEN? NO / YES (if yes, please

NO

STCW CERTIFICATES

CERTIFICATE
STCW CERTIFICATES CHECKLIST
NUMBER

1 - Certificate of Competency ( CoC ) CCE200001004320

2 - General Operator Certificate ( GMDSS )

3 - Flag State Endorsement for Certificate of Competency

4 - Flag State Endorsement for General Operator Certificate

ERM2019C1450281
5 - Bridge / Engine Resource Management Certificate
297
6 - Deck Ratings / Engine Ratings Watchkeeping Certificate
(COP II/4/5 or COP III/4/5)
7 - ETO / ETR Certificate
( III/6 / III/7 )

8 - Basic Safety Training ( BST ) BT445202942

PSCRB2291201161
9 - Proficiency in Survival Craft and Rescue Boat ( PSCRB )
58

10 - Personal Safety & Social Responsibility ( PSSR )

11 - Advance Fire Fighting / Fire Prevention & Fire Fighting

( AFF ) / ( FP&FF )
AFF1842010337

12 - Medical First Aid ( MFA ) MEFA-004-08-18

13 - Medical Care Onboard ( MCOB )

14 - Ship Security Officer ( SSO ) 16/Dec/8059

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15 - Security Training for Seafarers with Designated Security Duties

(SDSD )

16 - Crane Certificate

17 - Welding Certificate

18 - Ship's Cook Certificate - MLC 2006 compliance

19 - ECDIS

PREVIOUS SEA EXPERIENCE

Note: Sequence for entering sea service records: Latest service should be entered at row no. 1 and then old

NAME OF
RANK NAME OF VESSEL VESSEL TYPE
COMPANY

SOUTHFIELD
Chief Engr. M/V SPENDOR KEELUNG GENERAL CARGO
AGENCY INC.
SOUTHFIELD
Chief Engr. M/V VELVET GENERAL CARGO
AGENCY INC.
SOUTHFIELD
Chief Engr. M/V SABRINA BULK CARRIER
AGENCY INC.
88 ACES MARITIME
Chief Engr. M/V SKY GLOBE SERVICES BULK CARRIER
INCORPORATED
MAGSAYSAY
Chief Engr. SBI ORION MARITIME BULK CARRIER
CORPORATION
MAGSAYSAY
Chief Engr. SBICOUGAR MARITIME BULK CARRIER
CORPORATION
MAGSAYSAY
Chief Engr. SBI ORION MARITIME BULK CARRIER
CORPORATION
MAGSAYSAY
Chief Engr. SBI ORION MARITIME BULK CARRIER
CORPORATION
PHILIPPINE
Second Engr. M/V KRISTINITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Second Engr. M/V ROSITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Second Engr. M/V CARMENCITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Second Engr. M/V ROSITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Third Engineer M/V ISABELITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Third Engineer M/V LIVANITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Fourth Engr. M/V BENARITA TRANSMARINE BULK CARRIER
CARRIERS INC.

03+000Prepared by: HSE Department Approved by: 3CEO 03+000Rev. 04 July 2023
03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

PHILIPPINE
Fourth Engr. M/V ELLENITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V ROSITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V ELLENITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V FERMITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V NORITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V LIVANITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V MARIA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Motorman M/V SENORITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Wiper M/V NORITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Wiper M/V LUNITA TRANSMARINE BULK CARRIER
CARRIERS INC.
PHILIPPINE
Engine cdt. M/V NORITA TRANSMARINE BULK CARRIER
CARRIERS INC.
DECLARATION

HAVE YOU EVER BEEN CONVICTED FOR ANY OFFENCE? NO / YES (if yes, please specify)

NO

HAVE ANY CERTIFICATES OF COMPETENCY OR LICENSE ISSUED TO YOU EVER BEEN INVALIDAT

NO

I hereby certify that the above information as provided by me is true, complete and accurate to the best of my
any false statement in this Employment Application is in itself sufficient ground for dismissal from the Compa

NAME: BELLOSILLO ,GIDEON

SIGNATURE

03+000Prepared by: HSE Department Approved by: 4CEO 03+000Rev. 04 July 2023
 03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

DATE AVAILABLE : NOVEMBER

FIRST NAME : GIDEON

WEIGHT : HEIGHT :
73 165
(kilograms) (centimeters)

BMI
26.81
(Normal 18.5 to 22.9):

PLACE OF BIRTH : BALASAN, ILOILO

LOT 6 VIST RIVA SUBD.,FRUTO SANTOS AVE. ZAPOTE, LAS PINAS CITY

EMAIL ADDRESS : gideonbellosillo6@gmail.com

EXPIRY DATE:
15/May/2029 NO OF PAGES EMPTY :
(dd-mmm-yy)

SCHENGEN VISA EXPIRY

DATE (dd-mmm-yy)
EXPIRY DATE:
3/Sep/2027
(dd-mmm-yy)

NOK RELATIONSHIP : WIFE

NOK ADDRESS : BLK.2, LOT 6 VIST RIVA SUBD.,FRUTO SANTOS AVE. ZAPOTE, LAS PIN

NOK DATE OF BIRTH :

DATE OF EXPIRY:
(dd-mmm-yy)

03+000Prepared by: HSE Department Approved by: 5CEO 03+000Rev. 04 July 2023
 03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

(if yes, please specify)

O / YES (if yes, please specify)

DATE OF ISSUE
TRAINING CENTRE PLACE OF ISSUE
(dd-mmm-yy)

MARINA COP MANILA 10/Dec/2020

Southern Institute of Maritime

MANILA 19/Jun/2019
Studies,Inc.

MARINA COP MANILA 10/Dec/2020

MARINA COP MANILA 10/Dec/2020

MARINA COP MANILA 27/Oct/2020

MARINA COP MANILA 1/Mar/2008

MARINA COP MANILA 3/Nov/2015

03+000Prepared by: HSE Department Approved by: 6CEO 03+000Rev. 04 July 2023
 03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

ow no. 1 and then older services downward.

ENGINE MAKE, TYPE, TRADING SIGN ON

FLAG GRT
POWER (BHP / KW) AREA (dd mmm yy)

PANAMA 6,736 MAKITA / 3,120KW FAR EAST 8/Apr/2024

MARSHALL MAN B&W M-C /
23,759 WORLD WIDE 21/Apr/2023
ISLAND 8050KW
MAN B&W M-C /
PANAMA 34,515 WORLD WIDE 30/May/2022
8050KW
MARSHALL MAN B&W M-C /
32,929 WORLD WIDE 19/Dec/2020
ISLAND 8050KW
MARSHALL
36,421 MAN B&W / 8400KW WORLD WIDE 8/Sep/2019
ISLAND
MARSHALL
36,449 MAN B&W / 7907 WORLD WIDE 11/Oct/2018
ISLAND
MARSHALL
36,421 MAN B&W / 8400 WORLD WIDE 26/May/2018
ISLAND
MARSHALL
36,421 B&W / 7907 WORLD WIDE 22/Nov/2017
ISLAND
PANAMA 32,315 Bergen / 8400 WORLD WIDE 18/Apr/2015

PANAMA 25,777 B&W / 7907 WORLD WIDE 29/Apr/2014

PANAMA 32,279 B&W / 8400 WORLD WIDE 1/Jul/2013

PANAMA 25,777 B&W / 7907 WORLD WIDE 15/Jun/2012

PANAMA 32,297 MAN B&W / 8400 WORLD WIDE 11/Feb/2011

PANAMA 26,044 MAN B&W / 10444 WORLD WIDE 7/Feb/2010

PANAMA 23,594 MAN B&W / 6445 WORLD WIDE 24/Mar/2009

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PANAMA 32,600 MAN B&W / 6990 WORLD WIDE 6/Mar/2008

PANAMA 25,777 MAN B&W / 7907 WORLD WIDE 21/Feb/2007

PANAMA 32,600 MAN B&W / 6990 WORLD WIDE 12/Feb/2006

PANAMA 30,053 MAN B&W / 7800 WORLD WIDE 11/Dec/2004

PANAMA 22,135 MAN B&W / 5931 WORLD WIDE 23/Sep/2003

PANAMA 26,044 B&W / 10444 WORLD WIDE 23/Jun/2002

PANAMA 24,844 B&W / 8206 WORLD WIDE 11/Apr/2002

PANAMA 32,379 MAN B&W / 7244 WORLD WIDE 11/Jan/2001

PANAMA 22,135 MAN B&W / 5931 WORLD WIDE 28/Nov/1999

PANAMA 32,600 MAN B&W / 6990 WORLD WIDE 18/Nov/1998

PANAMA 22,135 MAN B&W / 5931 WORLD WIDE 30/Nov/1997

se specify)

ER BEEN INVALIDATED, REVOKED OR SUSPENDED? NO / YES (if yes, please specify)

urate to the best of my knowledge. I further understand that any willful act on my part in withholding information o
missal from the Company.

DATE: 19-Oct-24

03+000Prepared by: HSE Department Approved by: 8CEO 03+000Rev. 04 July 2023
 03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

Photo

VE. ZAPOTE, LAS PINAS CITY

03+000Prepared by: HSE Department Approved by: 9CEO 03+000Rev. 04 July 2023
03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

DATE OF EXPIRY
(dd-mmm-yy)

10/Dec/2025

UNLIMITED

10/Dec/2020

10/Dec/2025

27/Oct/2025

UNLIMITED

UNLIMITED

03+000Prepared by: HSE Department Approved by:10

CEO 03+000Rev. 04 July 2023
03+000SKEIRON Logistics Pte LtdAPPLICATION FOR EMPLOYMENT 03+000CRW 03

SIGN OFF NO OF
(dd mmm yy) DAYS

28/Aug/2024 142 Date inserted should be in the same format as per sample

20/Nov/2023 213

31/Jan/2023 246

28/Oct/2021 313

17/Sep/2020 375

18/Apr/2019 189

2/Sep/2018 99

25/May/2018 184

22/Aug/2015 126

11/Mar/2015 316

29/Mar/2014 271

12/May/2013 331

6/Nov/2011 268

19/Oct/2010 254

25/Nov/2009 246

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CEO 03+000Rev. 04 July 2023
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30/Jan/2009 330

20/Oct/2007 241

11/Nov/2006 272

16/Sep/2005 279

22/May/2004 242

14/Mar/2003 264

22/May/2002 41

20/Nov/2001 313

4/Aug/2000 250

5/Jul/1999 229

21/Aug/1998 264

hholding information or making

03+000Prepared by: HSE Department Approved by:12

CEO 03+000Rev. 04 July 2023