MA Transit Express ( ) rus | eng
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"-" ( 4000) , .


For seafarers

Application form for cruise vessels

Position applied for *
Date available *
Nationality

General information

Family name *
Christian name *
Fathers name *
Mothers name *
Date/Place of birth
License nr./Grade *
Other licenses
US C1/D Visa expire
ID code
Marital status
Children (name/DOB)
Home address *
Tel *
Mob
E-mail *
Next of kin name/address
English language knowledge *
Speak other languages

Seaman's book Exp.
Country Height
Seaman's passport * Exp.
Port Width
International p.port * Exp.
Country Clothes/shoes

Education *

I. M. O. Licenses

Endorsement of License Exp
STCW RULES
A R P A Certificate Exp
Radar Observation & Plotting Exp
G.M.D.S.S. Certificate Iss
Endorsement exp
STCW78/95 (A-VI/1) - Basic Exp
Advanced Fire Fighting (A-VI/3) Exp
Carrying Dangerous & Hazardous Cargoes (B-V/4,5) Exp
Bridge Team Management Exp
First aid (medical care) (A-VI/4-1,2) Exp
Proficiency in Survival Craft (A-VI/2) Exp
Maintenance of electrical & electronic equipment Exp
Compressed air breathing-apparatus Exp
Certificate for RO/RO passenger vessel Exp
Passenger Ship Crowd Management Training Exp
Passenger Ship Passenger Safety Training Exp
Passenger Ship Crisis Management Training Exp
Passenger Ship Familiarization Training Exp
Passenger Ship Safety Training Exp
Ships Safety Officer Exp
Medical Fitness Certificate Exp
Yellow Fever Vaccination Exp
 
Other Licenses
 
Exp.
Exp.
Exp.
Exp.
Exp.

SEA SERVICE (last five years):

Total years of service
Expected min wage, usd *

Place of employment #1:

Vessels name
RANK
FM/TO
GRT
Engine
BHP
Aux Engine
Kind of Automatic
Kind of refsystem
Quantity of passengers
Kind of work
FLAG / Built
Reason of discharge
Crew Agency
Principal Company

Place of employment #2:

Vessels name
RANK
FM/TO
GRT
Engine
BHP
Aux Engine
Kind of Automatic
Kind of refsystem
Quantity of passengers
Kind of work
FLAG / Built
Reason of discharge
Crew Agency
Principal Company


REFERENCES

VESSEL
SHIPOWNER / SHIPMANAGER NAME / ADDRESS
CONTACT PERSON
TEL No.
FAX No.
E-mail
 
VESSEL
SHIPOWNER / SHIPMANAGER NAME / ADDRESS
CONTACT PERSON
TEL No.
FAX No.
E-mail
 
VESSEL
SHIPOWNER / SHIPMANAGER NAME / ADDRESS
CONTACT PERSON
TEL No.
FAX No.
E-mail
 
DATE OF SIGNING

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