Photo crew application form

PHOTO

CREW APPLICATION FORM

APPLICATION DATE

REFER BY

POSITION APPLIED

EXPECTED SALARY

1. PERSONAL DATA

NAME

DATE OF BIRTH

PLACE OF BIRTH

HEIGHT

WEIGHT

NATIONALITY

MARITAL STATUS

ADDRESS

MOBILE

E-MAIL ADDRESS

2. NEXT OF KIN

NAME

RELATIONSHIP

ADDRESS / MOBILE

3. TRAVEL DOCUMENT

NAME OF DOCUMENT

NUMBER

ISSUED DATE

EXPIRY DATE

ISSUED BY

PLACE OF ISSUE

PASSPORT

CDC

4. CERTIFICATE OF COMPETENCY

COURSE NAME

NUMBER

ISSUED DATE

EXPIRY DATE

ISSUED BY (AUTHORITY)

ISSUED AT

5. CERTIFICATE OF PROFICIENCY

COURSE NAME

NUMBER

ISSUED DATE

EXPIRY DATE

ISSUED BY (AUTHORITY)

ISSUED AT

PERSONAL SAFETY AND SOCIAL RESPONSIBILITY

PERSONAL SURVIVAL TECHNIQUE

FIRE PREVENTION AND FIRE FIGHTING

ELEMENTARY FIRST AID

6. SEA SERVICE RECORDS

COMPANY NAME

RANK

NAME OF VESSEL

SIGNED ON

SIGNED OFF

VESSEL TYPE

GRT

FLAG

I hereby certify that the above information are true and correct to the best of my knowledge and belief.

Yours faithfully,

Дата добавления: 2015-09-30