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PRELIMINARY APPLICATION FOR EMPLOYMENT CMO 02 Sheet 1
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First name | Middle name | Last name/Surname |
Nationality | Date of birth (dd/mm/yy) | Place of birth |
Post Applied for | |
Willing to accept lower rank Yes No | Available from / / |
Contact Address | Documents | Issued on | Valid Until | ||||
| Passport: (Country) |
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| Seaman’s Book: National |
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City | Liberian: |
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Phone: | Panamanian: |
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Eye Colour: | Hair Colour: | Height: | Weight: | ||||
Highest Competency Certificate Held | Dangerous Cargo Endorsement (**) | ||||
Issuing Authority | Grade (*) | Valid until | Petroleum | Chemical | Gas |
National (Country:) |
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Liberian |
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Panamanian |
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Bahamian |
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Others |
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(*) Specify whether: (**) Specify whether:
Dk Class 1 = Master FG Eng Class 1 = 1st Class (M), (S), (M+S) R/O Class 1 In charge: Highest Grade
2 = 1st Mate FG 2 = 2nd Class (M), (S), (M+S) R/O Class 2 Assistant: Watch keeper at cargo watch
3 = 2nd Mate FG 3&4 = Class 4(M) R/O R/T only
4 = NWKO
STCW & Specialised Courses Attended – Including Special Qualifications (***) | |||||
Pers Sea Survival | Prof in Surv Craft | Basic First Aid | Medicare | Basic F-Fighting | Adv. F-Fighting |
Radar Observer | Radar Simulator | ARPA | Ship Simulator | Marine Comm | GMDSS |
Nav Command & Control | Liq. Cargo Simulator | E/R Simulator | Revalidation | A/B |
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Tkr Safety (Pet) | Tkr Safety (Chm) | Tkr Safety (LPG) | Tkr Fam (Pet)) | Tkr Fam (Chm) | Tkr Fam (LPG) |
Liberian SCC | Liberian A.B. | Liberian Oir | Liberian GMDSS | Others: (Please specify) |
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(***) Tick for course done and still valid
Sea Experience | |||||||||
Company | Vessel | Flag | Type (****) | DWT | M/Engine | BHP | Rank | From (dd/mm/yy) | To (dd/mm/yy) |
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(****) Use only following abbreviations for vessel type:
GCD - General Cargo B/C - Bulk Carrier CON - Cellular Container MLP- Multi-Purpose O/O - Ore Oil
OBO - Ore/Bulk/Oil NC - Tanker Crude TNP - Tanker Product TNS - Tanker Storage INV - VLCC/ULCC
GAS - LPG/LNG Carrier CHM - Chem Carrier PAS - Passenger Ships R/O - Ro/Ro Carriers LSH - Lash
OSV- Offshore Supply Vessel DRG - Dredgers SRV - Survey vessels LOG - Log/Timber VL - Naval Ships
Please give reference from 2 recent employers who we may contact for references | ||
Name of Company |
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Name of person to contact |
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Address |
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Telephone |
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I hereby declare that the above is true
Place ________________________________ Date ______________________________ Signature __________________________
Дата добавления: 2015-11-04; просмотров: 29 | Нарушение авторских прав
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