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Employment Application Form: Personal Details

This document is an employment application form for seafarers seeking tanker positions. It requests personal details like name, date of birth, passport information, license details, certification details, sea service history, references, and next of kin information. The applicant would fill this out to apply for tanker jobs and document their qualifications and experience.

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Serg Bezdna
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© © All Rights Reserved
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Download as XLSX, PDF, TXT or read online on Scribd
541 views

Employment Application Form: Personal Details

This document is an employment application form for seafarers seeking tanker positions. It requests personal details like name, date of birth, passport information, license details, certification details, sea service history, references, and next of kin information. The applicant would fill this out to apply for tanker jobs and document their qualifications and experience.

Uploaded by

Serg Bezdna
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Application Form for Seafarers_Tanker Template

EMPLOYMENT APPLICATION FORM


Rank: Date Available for Joining:
Vessel:

Personal Details
Surname: First Name: Photo:
Date of Birth: Place of Birth: Nationality:
Home Address:
Phones:

Nearest Airport: Nearest International Airport:

Documents

Passport No. Issued on: Expiry date:


S/book No. Issued on: Expiry date:
US visa C1/D Issued on: Expiry date:

LICENCE PARTICULARS
MOT Grade Cert No Place of Issue Date of Issue Expiry date
National License
Endorsement
Tanker License Crude Oil
Liquid chemical
Liquefied gas

CERTIFICATES Cert No Date of Issue Expiry date


G.M.D.S.S.
G.M.D.S.S. Endorsement
Proficiency in Survival Craft
Basic Safety Training
Advanced Fire Fighting
Dangerous and Hazardous Substances
Dangerous and Hazardous Substances in Packages or
Solid Form
ROP/ARPA
Ship Security Officer
Medical First Aid
Medical Care Onboard
Basic Training for Oil/Chemical Tanker Cargo
Operations
Advanced / Specilized Training for Oil/Chemical
Tanker Cargo Operations
Basic Training for Gas Tanker Cargo Operations
Advanced / Specilized Training for Gas Tanker Cargo
Operations
Liquid Cargo Handling Simulator
Tanker Fire Fighting
FRAMO Hydraulic Cergo Piping System
COW/IGS
ISM Code Familiarization
Bridge/Engine Team Management
Bridge/Engine Resourse Management
ECDIS
ECDIS Type Specific
Security-related training & instruction for all seafarers

Ship Security Officer


H2S
Yellow fever

Please proceed to SEA SERVICE


A B C D E F G H I
1 Application Form for Seafarers_Tanker Template
2 SEA SERVICE
and Engine
3 Name of Vessel YoB
Built Flag Type of Vessel
(Type) DWT and HP Rank Period of Service Name of Owners
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18 References Personal Data:
19 Name of company: Weight, kg: Height, cm:
20 ( No. Eyes: Hair:
21 Name of company: Overall size: Safety shoes:
22 ( No.
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24 Pre-Sea Training / Maritime School Grade/Qualification
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27 Exp. with Multinational Crew: Level of English:
28 Nationalities:
29
30 Next of kin
31 Name / Relationship
32 Home address:
A B C D E F G H I
33 Phones:

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