Revision: Issue 2/6 Doc. no.
: 06-04-002
Date: January 2017 Page: 1 of 3
VESSEL Skypower APPRAISAL DATE DD/MM/YY 21.02.2017
SEAFARER NAME Oleksandr Levandovskyi RANK 3rd Officer
SIGN-ON DATE DD/MM/YY 27.07.2016 SIGN-OFF DATE DD/MM/YY
REASON OF APPRAISAL MASTER’S CHANGE OF COMMAND
State
SIGN OFF
reason:
OTHER Specify: Promotion
Appraisal report for seafarers
GRADE
APPRAISAL ELEMENTS N/A REMARKS
1 2 3 4 5
A. PROFESSIONAL SKILLS EVALUATION
1. HSSQE Awareness
2. Awareness of duties and responsibilities
3. Awareness of Emergency Response procedures
4. Compatibility with Company’s QHSE Procedures
and Policies
5. Language skills (English)
AVERAGE GRADE FOR A. 4,8
B. GENERAL CHARACTERISTICS EVALUATION
6. Personal effort
7. Physical condition
8. Teamwork
9. Initiative
10. Sense of order, housekeeping
11. Discipline
12. Stress tolerance
13. Loyalty
AVERAGE GRADE FOR B. 4,75
C. ONLY FOR OFFICERS
14. General watchkeeping conduct
15. Planning and organization of work, including
administrative paperwork duties
16. Interest in applying safe working practices
17. Capability of setting priorities for
work/activities
18. Capability of training/assisting inexperienced
crew members to acquire skills/knowledge of
their duties
19. Acquaintance with equipment/systems onboard
and their operation
20. Knowledge on critical equipment with regard
to operation, maintenance, repairs and
amending parameters, such as changing alarm
set points (where applicable)
21. Ship handling and collision avoidance (for Deck
Officers)
22. Chart work: corrections, use of proper scale
charts, etc. (for Deck Officers)
23. Navigation conduct and bridge team (for Deck
Officers)
24. Passage planning, monitoring techniques, PI
and plotting, squat calculations, UKC (for Deck
Officers)
Submission Frequency: 6 months / Receiver: Crewing Form to be filed: D-8
Issued by: DPA/QHSE manager Approved by: Managing director
Revision: Issue 2/6 Doc. no.: 06-04-002
Date: January 2017 Page: 2 of 3
GRADE
APPRAISAL ELEMENTS N/A REMARKS
1 2 3 4 5
25. Knowledge of electronic navigational aids (for
Deck Officers)
26. Bridge equipment maintenance (for Deck
Officers)
27. Tank cleaning operations (for Deck Officers)
28. Knowledge-planning-handling of cargo / ballast
operations and stability (for Deck Officers)
29. Vessel’s machinery maintenance (for Engine
Officers).
30. Engineering knowledge (for Engine Officers)
31. Participation in planning, cargo line setting
and execution of cargo and ballast operations
(for Junior Officers)
AVERAGE GRADE FOR C. 4,8
TOTAL AVERAGE GRADE (A+B+C / 3) 4,78
Any recommendations for additional training to be recorded below and in the seafarer’s personal Training
Log (form 06-06-007):
Training needs:
D. EVALUATION COMMENTS
COMMENTS
C/E (IF APPLICABLE) NAME/SIGNATURE DATE
COMMENTS
3rd Officer Oleksandr Levandovskyi has presented himself as a responsible officer . Showed high QHSE
awareness and performed correct actions during inspections , drills and loading/discharging operations .
MASTER NAME/SIGNATURE KUZIKYAN EDUARD / DATE
21.02.2017
COMMENTS
SEAFARER SIGNATURE DATE
21.02.2017
THE FOLLOWING SECTIONS ARE ‘CONFIDENTIAL’ AND ARE NOT TO BE REVIEWED BY THE SEAFARER
E. ASSESSMENT OF POTENTIAL
YES NO REASON in case of NO / REMARKS
Recommended for re-employment?
Ready for promotion?
Overall Good . Is well-trained for 2nd officer rank . Sufficient knowledge of electronic
impression navigational aids . His previous experience as 2nd officer is considered enough to
comply with high standards of Company’s QHSE policies .
Submission Frequency: 6 months / Receiver: Crewing Form to be filed: D-8
Issued by: DPA/QHSE manager Approved by: Managing director
Revision: Issue 2/6 Doc. no.: 06-04-002
Date: January 2017 Page: 3 of 3
MASTER NAME/SIGNATURE DATE
C/E (IF APPLICABLE) NAME/SIGNATURE DATE
F. COMPANY COMMENTS
OPERATIONS MANAGER DATE
NAME/SIGNATURE DD/MM/YY
TECHNICAL MANAGER DATE
NAME/SIGNATURE DD/MM/YY
CREWING MANAGER DATE
NAME/SIGNATURE DD/MM/YY
DPA/QHSE MANAGER DATE
NAME/SIGNATURE DD/MM/YY
MANNING AGENT ADVISED YES NO DATE
Copy sent to Manning Agent?
EVALUATION FORM’S COMPLETION INSTRUCTIONS
This form refers to two general appraisal areas (A and B), the Professional Skills and the General
Characteristics evaluation which applies for ALL seagoing staff, except the Master and the C/E.
Furthermore, and only for vessels’ Officers, another area (C) of evaluation applies.
The person making the appraisal will have to grade from 1 to 5 in each distinct appraisal area by ()
under the granted appraisal score. The granted appraisal scores should reflect the following:
- 5 “excellent” means that the person’s capacity is outstanding at a level much higher than is usually
encountered.
- 4 “above expectations” means that person’s capacity is high, meaning significantly better than what
would normally pass for acceptable.
- 3 “satisfactory” means that the person’s capacity is in line with normal expectation according to the
duties of his position.
- 2 “fair” means that the person’s capacity is below expectations but with the proper training in this
specific area he can be sufficiently improved. The assessor should propose required training in order
relevant identified gaps to be addressed.
- 1 “unsatisfactory” means that the person’s capacity is inadequate in this particular area and the
possibility for the person to be sufficiently improved, even with additional training, is problematic.
An important factor in the further improvement of seafarer professional capacity / quality is the level of
his training. Consequently, for any identified training needs the seafarer’s personal training log (form 06-
06-007) has to be completed. Particularly, in every case where a score of 2 has been given, remarks
describing the kind of training that is required for improvement in this particular area must be completed.
As you can appreciate, the score of 1 constitute a special case. For this reason, the assessor who grants
this score should normally describe in the “Comments” section the reasons for this low score.
Submission Frequency: 6 months / Receiver: Crewing Form to be filed: D-8
Issued by: DPA/QHSE manager Approved by: Managing director
