APPLICATION FOR REVALIDATION OF A CERTIFICATE OF COMPETENCY

Transcription

1 APPLICATION FOR REVALIDATION OF A CERTIFICATE OF COMPETENCY A. PERSONAL PARTICULARS OF APPLICANT SURNAME:... FIRST NAMES:... DATE OF BIRTH:... COUNTRY OF BIRTH:... NATIONALITY:... ID/PASSPORT NO.: HEIGHT:...EYE COLOUR:... HAIR COLOUR:... PERMANENT ADDRESS: TELEPHONE NO.:...PORT: GENDER M F RACE B W C I HOME PROVINCE:.. HOME LANGUAGE. B. CERTIFICATE OF COMPETENCY TO BE REVALIDATED Signature of Candidate STCW 78 AS AMENDED Master Chief Engineer Chief Mate Chief Engineer (< 3000 kw) Chief Mate (< 3000GT) 2 nd Engineer Deck 2 nd Engineer (< 3000 kw) Master (< 200GT) Engineer Master (< 500GT) Master (< 3000GT) Endorsement Chief Engineer (< 750 kw) Master (< 200GT near coastal) Endorsement Chief Engineer (< 3000 kw) Master (< 500GT near coastal) Mate (< 500GT) Mate (< 500GT near coastal) Endorsement Chief Mate (<3000 GT) Endorsement Master (<3000 GT) Endorsement Master (<500 GT) STCW-F Deck fishing (< 24m) Chief Engineer (fishing) Deck fishing ( 24m) Chief Engineer (< 3000 kw fishing) Skipper fishing (< 24m limited waters) 2 nd Engineer (fishing) Skipper fishing (< 24m unlimited waters) Skipper fishing ( 24m limited waters) Skipper fishing ( 24m unlimited waters) Application for Revalidation of a Certificate of Competency 1 of 11

2 Master (< 500GT) Master (<3000GT) Chief Mate (< 3000GT) Master Master (< 200GT) Chief Mate Deck Master (< 200GT near coastal) Master (< 500GT near coastal) Mate (< 500GT) Mate (< 500GT near coastal) NON-STCW Master (Port Master (< 1600GT Port Skipper (< 200GT Port Chief Engineer (Port Chief Engineer (< 750kW Port Chief Engineer (< 1500kW Port Endorsement Chief Engineer (<1500kW Port Endorsement Chief Engineer (Port Note: Clerks must enquire if a candidate holds an additional endorsement for passenger, tanker or security when collecting the required documentation stated in tables that follow. C. DOCUMENTS TO ACCOMPANY APPLICATION: STCW 78 Deck Certification Proof of Identity 3 x colour passport-size photographs Medical certificate (SAMSA approved medical practitioner) SAMSA Eyesight certificate Proof of qualifying service (Discharge Book) or equivalent service Current certificate of competency Medical care certificate Medical first aid course certificate Advanced fire-fighting course certificate Fire prevention and firefighting course certificate GMDSS General Operator Certificate Long Range (L)/ Short Range (S) Radio Certificate $ Proficiency in Survival Crafts and Rescue Boats Personal Survival Techniques course certificate Personal Safety and Social Responsibilities course ENS Module 3 (Management level) * ENS Module 2 (Operational level) * Generic ECDIS course certificate * Security Awareness/ or Designated Security Duties/ or Ship Security * Only required for applicants not having 1 year s sea service in the preceding 5 years on vessels appropriately equipped, provided evidence of course completed successfully is submitted. $ Long or Short Range certificate dependent on voyage and according to equipment fitted Application for Revalidation of a Certificate of Competency 2 of 11

3 Deck fishing (< 24m) Deck fishing ( 24m) Skipper fishing (< 24m limited waters) Skipper fishing (< 24m unlimited waters) Skipper fishing ( 24m limited waters) Skipper fishing ( 24m unlimited waters) Chief Engineer Chief Engineer (< 3000 kw) 2 nd Engineer 2 nd Engineer (< 3000 kw) Engineer Chief Engineer (< kw) Chief Engineer (< 750 kw) Certification Endorsements STCW 78 Engineer Certification Proof of identity 3 x colour passport-size photographs Medical certificate (SAMSA-approved medical practitioner) SAMSA Eyesight certificate Proof of qualifying service (Discharge Book) or equivalent service Current certificate of competency Medical first aid course certificate Advanced fire-fighting course certificate Fire prevention and firefighting course certificate Proficiency in Survival Crafts and Rescue Boats Personal Survival Techniques course certificate Personal Safety and Social Responsibilities course Security Awareness/ or Designated Security Duties/ or Ship Security STCW-F Deck Certification ID document or passport 3 x colour passport-size photographs Medical certificate (SAMSA-approved medical practitioner) Proof of qualifying service (Discharge Book) or equivalent service Current certificate of competency Medical first-aid certificate SAMSA Eye test Certificate Medical care certificate Electronic Navigation Systems Module 1 & 2. Generic ECDIS course certificate $ Proficiency in Survival Craft and Rescue Boats Personal Survival Techniques Personal Safety and Social Responsibilities course Fire prevention and firefighting course certificate Advanced firefighting course certificate Long Range (L)/ Short Range (S) Radio Certificate L L S L S L GMDSS* Note: * required if candidate is sailing on vessels equipped with GMDSS equipment. $ required if vessel is fitted with ECDIS & in accordance with safe manning certificate Application for Revalidation of a Certificate of Competency 3 of 11

4 Master (Port Master (< 1600GT Port Skipper (< 200GT Port * Chief Engineer (fishing) Chief Engineer (< 3000 kw fishing) 2 nd Engineer (fishing) STCW-F Engineer Certification ID document or passport 3 x colour passport-size photographs Medical certificate (SAMSA-approved medical practitioner) SAMSA Eyesight certificate Proof of qualifying service (Discharge Book) or equivalent service Current certificate of competency Personal Safety and Social Responsibilities course Proficiency in Survival Craft and Rescue Boats Medical first-aid course certificate Advanced firefighting course certificate Non-STCW Deck Certification ID book or passport 3 x colour passport-size photographs Medical certificate (SAMSA-approved medical practitioner) SAMSA Eyesight certificate Proof of qualifying service (Discharge Book) or equivalent service Current certificate of competency Medical first aid course certificate Fire prevention and firefighting course certificate Advanced firefighting course certificate Personal Survival Techniques course certificate Personal Safety and Social Responsibilities course Note: * under 200GT is a limitation for command purposes, however this column/these requirements can be used to apply for any Skipper Port Operations Certificate Application for Revalidation of a Certificate of Competency 4 of 11

5 Chief Engineer (Port Chief Engineer (< 750kW Port Chief Engineer (< 1500kW Port Endorsement Chief Engineer (<1500kW Port Endorsement Chief Engineer (Port Non-STCW Engineer Certification ID document or passport 3 x colour passport-size photographs Medical certificate (SAMSA-approved medical practitioner) SAMSA Eyesight certificate Proof of qualifying service (Discharge Book) or equivalent service Current certificate of competency Medical first aid course certificate Fire prevention and firefighting course certificate Advanced firefighting course certificate Application for Revalidation of a Certificate of Competency 5 of 11

6 Deck - GT Engineer - Propulsion power (kw) Type of service (unlimited, nearcoastal, port operations) Engineers Steam/ Motor Deck and engineer officer sea service Particulars of sea service should be taken from the Seaman s Record Book and/or Certificate(s) of Discharge. Name of ship Type of ship Tankers LNG/ Oil/ Chemical/ Rank Dates Actual period Assessed period Passenger/ Bulk Carriers/ Supper Yachts/ Container/ Ro-Ro/ Mining/ Offshore supply/ Tugs/ AH vessels/ DP vessels/ For Official use only. From To Months Days Months Days Net qualifying service Date:... Signature of examiner: Application for Revalidation of a Certificate of Competency 6 of 11

7 D. Applicants not having served 1 year at sea in the preceding 5 years and holding valid certification. Comply with section C above and: 1. Have been employed in the Maritime industry for at least 1 year in the last 5 years in a capacity, which in the opinion of the relevant senior examiner, is equivalent to sea service OR 2. Having completed three months approved sea service in the rank specified in the certificate held during the preceding six months AND EITHER a. For deck officers at operational level, have successfully completed an approved Electronic Navigation Systems (ENS) course and an approved ECDIS course OR b. For deck officers at management level, have successfully completed an approved Electronic Navigation Systems and ECDIS course. E. Applicants not having served 1 year at sea in the preceding 5 years and holding expired certification 1. Comply with Sections C and D above OR 2. Comply with section C above AND 3. Have completed approved sea service in the appropriate rank or in a lower rank (see Safe Manning, Training and Certification Regulations, Regulation 3(2)(d)(bb)), for a period of not less than 3 months in a supernumerary capacity OR 4. Having completed three months approved sea service in the rank specified in the certificate held during the preceding six months AND 5. Have been assessed at level 3 F. Specialized endorsements For tanker and passenger ship endorsements: 1. Demonstrate continued professional competence by showing service in the appropriate type of ship for at least 1 year in the preceding 5 years. OR 2. Complete an appropriate approved course at an accredited training provider. FOR OFFICE USE ONLY Fee received:..receipt No.:.Date: Signature of person receiving fee... Signature of candidate Use the following tables to choose the correct Certificates of Competency or endorsements. Use the right outermost column to indicate your choice. Applicable Regulations Merchant Shipping (Safe Manning, Training and Certification) Regulations 2013, as amended International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978, as amended Level: Management; Operational; Support; N/A Application for Revalidation of a Certificate of Competency 7 of 11

8 For Office use only: I have checked the attached documents and am satisfied that the holder of the certificate meets all the requirements for the revalidation of the following certificate of competency and related endorsements (if any): STCW DECK OFFICERS References and limitations. Certificate of competency Ref. Limitations Master II/2 None Chief Mate II/2 None Master (<3000GT) II/2 Master of a ship of less than 3000GT on unlimited voyages Chief Mate (<3000GT) II/2 Chief Mate of a ship of less than 3000GT on unlimited voyages Deck II/1 None Master (<500GT) II/3 Master of a ship of less than 500GT on unlimited voyages Mate (<500GT) II/3 in charge of a navigational watch on a ship of less than 500GT on unlimited voyages Master (<200GT) II/3 Master of a ship of less than 200GT on unlimited voyages Master (<500GT Near- II/3 Master of a ship of less than 500GT on near-coastal voyages Coastal) Mate (<500GT Near- Coastal) II/3 in charge of a navigational watch on a ship of less than 500GT on near-coastal voyages Master (<200GT Near- II/3 Master of a ship of less than 200GT on near-coastal voyages Coastal) Master (<1600GT Port Reg. 24 Master of a ship of less than 1600GT operating within a port operations area Master (Port Reg. Master of a ship of any tonnage operating within a port operations area 25 Skipper (Port Reg. 19 Master of a ship of less than 200GT operating within a port operations area Endorsements Ref Limitations Master (Mining II/2 Master of a ship of any tonnage engaged in mining operations Chief Mate (Mining II/2 Chief Mate of a ship of any tonnage engaged in mining operations Deck (Mining II/1 in charge of a navigational watch on a engaged in mining operations Master (<200GT Near- Coastal Non-Trading) II/3 Master of a ship of less than 200GT limited to non-trading vessels on near-coastal voyages Master (<200GT Non- Trading) II/3 Master of a ship of less than 200GT limited to non-trading vessels on unlimited voyages Mate (<500GT Near- Coastal Non-Trading) II/3 in charge of a navigational watch on a ship of less than 500GT limited to non-trading vessels on near-coastal voyages Mate (<500GT Non- Trading) II/3 in charge of a navigational watch on a ship of less than 500GT limited to non-trading vessels on unlimited voyages Master (<500GT Near- Coastal Non-Trading) II/3 Master of a ship of less than 500GT limited to non-trading vessels on near-coastal voyages Master (<500GT Non- Trading) II/3 Master of a ship of less than 500GT limited to non-trading vessels on unlimited voyages Deck (Non-Trading) II/1 in charge of a navigational watch on a ship of any tonnage limited to non-trading vessels on unlimited voyages Chief Mate (<3000GT Non- Trading) II/2 Chief Mate of a ship of less than 3000GT limited to non-trading vessels on unlimited voyages Master (<3000GT Non- Trading) II/2 Master of a ship of less than 3000GT limited non-trading vessels on unlimited voyages Master (Non-Trading) II/2 Master of a ship of any tonnage limited to non-trading vessels on unlimited voyages Chief Mate (Non-Trading) II/2 Chief Mate of a ship of any tonnage limited to non-trading vessels on unlimited voyages Application for Revalidation of a Certificate of Competency 8 of 11

9 STCW-F Deck s Certificate STCW-F Ref. Limitations Skipper Fishing ( 24m II/1 Master any ship engaged in fishing on unlimited waters Unlimited) Skipper Fishing (<24m II/1 Master of a ship of less than 24 metres engaged in fishing on Unlimited) unlimited waters Skipper Fishing ( 24m II/3 Master any ship engaged in fishing on limited waters Limited) Skipper Fishing (<24m II/1 Master of a ship of less than 24 metres engaged in fishing on Limited) limited waters Deck Fishing (<24m) II/2 in charge of a navigational watch on a ship of less than 24 metres engaged in fishing on unlimited waters Deck Fishing ( 24m) II/2 in charge of a navigational watch on any ship engaged in fishing on unlimited waters DECK RATINGS STCW, Fishing & Port Operations Certificate Ref. Limitations Ordinary Seafarer Deck II/4 Rating forming part of a navigational watch on sea-going vessels Able Seafarer Deck II/4 Able Seafarer on any ship on unlimited voyages Able Seafarer Deck (Port Regulation Able Seafarer on any ship limited to port operations 59 Able Seafarer Deck (Fishing) Regulation Able Seafarer on any ship engaged in fishing General Purpose Rating 60 Regulation 66 Efficient General Purpose Rating on any ship limited to port operations Certificate of Proficiency STCW Reference Elementary First Aid A-VI/1-3 Medical First Aid A-VI/4-1 Medical Care A-VI/4-2 Personal Survival Techniques A-VI/1-1 Personal Safety and Social Responsibilities A-VI/1-4 Fire Prevention and Fire Fighting A-VI/1-2 Advanced Fire Fighting A-VI/3 Basic Training A-VI/1 Survival Craft and Rescue Boats A-VI/2-1 Fast Rescue Boat A-VI/2-2 Basic Training Oil and Chemical Tankers A-V/1-1-1 Basic Training Liquefied Gas Tankers A-V/1-2-1 Advanced Training Oil Tankers A-V/1-1-2 Advanced Training Chemical Tankers A-V/1-1-3 Advanced Training Liquefied Gas Tankers A-V/1-2-2 Designated Security Duties A-VI/6-2 Ship Security A-VI/5 Security Awareness A-VI/6-1 Crowd Management and Passenger Safety A-V/2 Passenger Safety, Cargo Safety and Hull Integrity A-V/2 Crisis Management and Human Behaviour A-V/2 Pre-sea Training A-VI/ Application for Revalidation of a Certificate of Competency 9 of 11

10 STCW Engineer s Limitations Primary Limitations Motorships Only Combined Motor and Steam Not valid to operate and maintain power systems in excess of 1000 Volts Not permitted to work on complex coloured cables Certificate Ref: Limitations Chief Engineer III/2 Chief Engineer of a ship of unlimited power propulsion power Second Engineer III/2 Second Engineer of a ship of unlimited propulsion power Chief Engineer Chief Engineer of a ship of less than 3000kW propulsion power (<3000kW) Second Engineer Second Engineer of a ship of less than 3000kW propulsion power (<3000kW) Engineer III/1 in charge of an engineering watch on a ship of unlimited propulsion power Electro-Technical III/6 in charge of electronic equipment on board a ship of 1000 Volts or more Marine Motorman Grade 2 Chief Engineer of any vessel of less than 350kW propulsion power in charge of any vessel of less than 1000kW propulsion power on near-coastal voyages or limited waters Marine Grade 1 Motorman Chief Engineer of any vessel of less than 1000kW propulsion power on near-coastal or limited waters voyages in charge of an engineering watch on any vessel of less than 2000kW propulsion power on near-coastal or limited waters voyages in charge of an engineering watch of a vessel of less than 750kW propulsion power, but less than 500GT Marine Motorman Higher Grade Chief Engineer of any vessel of less than 2000kW propulsion power on near-coastal voyages or limited waters in charge of an engineering watch on any vessel of less than 3000kW propulsion power on near-coastal or limited waters voyages Chief Engineer of a near-coastal vessel of less than 1500kW propulsion power, but less than 500GT Chief Engineer on unlimited vessels of less than 1500kW propulsion power, but less than 500GT STCW & Port Operations Engineer Ratings. Certificate Reference Limitations Ordinary Seafarer Engine III/4 Rating forming part of an engineering watch on seagoing vessels Able Seafarer I Able Seafarer on any ship on unlimited voyages Engine Able Seafarer Regulation 63 Able Seafarer on any ship limited to port operations Engine (Port Electro-technical III/7 Rating assisting ETO onboard a ship of 1000V or more Rating General Purpose Rating Regulation 66 Efficient General Purpose Rating on any ship limited to port operations Application for Revalidation of a Certificate of Competency 10 of 11

11 STCW-F Engineering s Certificate Reference Limitations Marine Motorman Chief Engineer of any vessel of less than 1000kW propulsion power on near-coastal or limited waters voyages Grade 1 in charge of an engineering watch on any vessel of less than 2000kW propulsion power on near-coastal or limited Marine Motorman Higher Grade Second Engineer (Fishing) Chief Engineer (<3000kW Fishing) Chief Engineer (Fishing) waters voyages in charge of an engineering watch on any vessel of less than 3000kW propulsion power on near-coastal or limited waters voyages in charge of an engineering watch on fishing vessels of unlimited propulsion power Chief Engineer of a fishing vessel of less than 3000kW propulsion power Chief Engineer of a fishing vessel of any propulsion power Signature of examiner: Date: Name of examiner: Application for Revalidation of a Certificate of Competency 11 of 11