PHOTO (compulsory) |
POSITION:
Alternative position:
Date of availability: dd-mm-yyyy
SURNAME / NAME: |
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Date & Place of Birth |
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CITIZENSHIP: |
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NATIONALITY: |
| MARITAL STATUS: |
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POST BOX, ADDRESS (REGISTRATION) |
| NR. OF CHILDREN: |
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POST BOX, ADDRESS (RESIDENCE) |
| CHILDREN (NAME, DATE OF BERTH) |
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TOWN / COUNTRY: |
| PHONE; |
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PHONE: | E – MAIL: | ||
NEAREST AIRPORT | POST BOX, ADDRESS (RESIDENCE) |
MARINE EDUCATION
NAME OF SCHOOL | FROM | TILL | TYPE OF DEGREE RECEIVED |
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Height | Weight | Overall | Shoes |
colour of eyes | colour of hair | blood type | |
THE DATE OF VISA EXPIRE | USA | Schengen | OTHERS: | |||||||
REGISTERED NUMBER OF THE VISA | ||||||||||
FOREIGN LANGUAGES KNOWLEDGE | ENGLISH | GERMAN | SPANISH | OTHERS: | ||||||
SATICFACTORY, GOOD, VERY GOOD,FLUENT |
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List of the Documents | Number | Issuing Date and country | Expire date | |||||||
National passport |
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Travel Passport |
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Seafarer's identity document |
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Seaman's book |
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other Seaman’s book |
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national Licence FOR OFFICER / grade: |
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NATIONAL CERTIFICATE FOR RATING |
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endorsement: |
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GMDSS GENERAL operator |
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GMDSS GENERAL operator Endorsement |
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ROP |
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ARPA |
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Personal survival techniques, fire prevention AND Fire-fighting, elementary first aid, personal safety and social Responsibility |
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Proficiency in survival craft and rescue boats |
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Advanced fire-fighting |
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Medical care course |
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Medical first-aid |
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SSO - Ship security officer |
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section A-vi/6, table A-vi/6-2 |
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BTM / ETM (Bridge / engine team management) |
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Ships carrying dangerous and hazardous cargoes |
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DANGEROUS AND HAZARDOUS CARGOES USA |
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Maneuvering & ship handling |
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ECDIS (electronic charts) |
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ISM Code |
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AIS |
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Certificate of health |
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Vaccination / Re vaccination against yellow fever |
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SEA SERVICE FOR THE LAST 5 YEARS (OR LAST 5 YEARS)
SHIP'S NAME AND YEAR OF BUILT | SHIP'S TYPE | FLAG | DWT/ BRT | M/E TYPE | KWT | RANK | SIGN ON | SIGN OFF | SHIPOWNER /EMPLOYER |
WORKING EXPERIENCE AND REFERENCES
Indicate trading areas where you had working experience: |
Did You work with mixed crew? If yes, what the nationalities?: |
REFERENCES CAN BE RECEIVED FROM LAST 3 COMPANIES (CUMPULSORY)
NAME | RANK | Contact details |
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APLLICANTS SIGNATURE____________
DATE_____________________________
Дата добавления: 2015-08-27; просмотров: 59 | Нарушение авторских прав
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| '' Think once,think twice,think Dance - 2’' Short Term EVS Project (1st May – 1st June of 2013) | | | Father's name: Oleksandrovich |