Application Form for Crewing

Please fill in your personal data, so we could offer you something in accordance with your possibilities and experience.

Personal Details

Next of Kin

Travel Documents

Travel Document Number Place of Issue Issued on Expires on
National Passport:
Seaman’s Book:
US Visa:
Schengen Visa:

Education

Name of Marine School Attended Qualification or Diploma From To

Licences

License(s) Held Limitation(s) on GRT (if any) Grade/Class of license

Certificates

STCW Certificates Number Place of Issue Issued on Expires on
Certificate of competency
Endorsement STCW
Basic Safety Training (A-VI/1)
GMDSS Gen. Operator Certificate (A-IV/2)
GMDSS Gen. Operator Endorsement (A-IV/2)
Radar Observation and Plotting (A-II/1,2)
Automatic Radar Plotting Aids (ARPA) (A-II/1,2)
Prof. in Survival Craft& Rescue Boats (A-VI/2-1)
Prof. in Fast Rescue Boats (A-VI/2-2)
Advanced Fire Fighting (A-VI/3)
Medical First Aid (A-VI/4-1)
Ship’s Medical Care (A-VI/4-2)
Ship Security Officer SSO (VI/5)
Ship Safety Officer
Dangerous & hazardous cargo (B-V/4, B-V/5)
Ro-Ro passenger ships (A-V/2)
Bridge Team Management
Electronic Chart Display & Information System
DP Basic
Medical Certificates Number Place of Issue Issued on Expires on
Physical Examination
Yellow Fever Vaccination
Cholera Vaccination

Previous experience

Previous Sea Service (Please start with last contracts)
  From To Vessel Flag GRT Type Position Company
1
2
3
4
5
6
7
8
9
10

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