Crew Members Application Form

CREWS PERSONAL PARTICULARS

1. First Name Middle Name Last Name
2. Email
3. Position Applied for
4. Marital status Nationality
5. Passport NO Place of issue
Date of issue
(dd/mm/yyyy)
Date of expiry
(dd/mm/yyyy)
6. Seaman book no. Place of issue
Date of issue
(dd/mm/yyyy)
Date of expiry
(dd/mm/yyyy)
7. Date of birth
(dd/mm/yyyy)
Place of birth
8. Address
9. Education
10.

Certificate of competency and others

Master Marine (Class 1)
Issue Date (dd/mm/yy)


Chief Mate (Class 2)
Issue Date (dd/mm/yy)


2nd Mate (Officer in charge)
Issue Date (dd/mm/yy)


Chief Engineer (Class 1)
Issue Date (dd/mm/yy)


2nd Engineer (Class 2)
Issue Date (dd/mm/yy)


3rd Engineer (Officer in charge)
Issue Date (dd/mm/yy)




11.

Training Certificates

Ship Security Officer
Issue Date (dd/mm/yy)


Basic Safety Training
Issue Date (dd/mm/yy)


Rigging & Slinging
Issue Date (dd/mm/yy)



12. Country
13. Area code
14. Last drawn salary
15. Nearest airport
16. Place of repatriation after finishing of contract

NEXT-OF-KIN

17. Name
18. Relationship to crew
19. Address
20.
Contact telephone no.
(including country/area code)
Home Cellphone/others
21. Fathers name

TO WHOM IT MAY CONCERN

FAMILY DETAILS CHILDREN

NO. NAME SEX DATE OF BIRTH (dd/mm/yyyy) PLACE OF BIRTH
1.
2.
3.
4.
5.
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