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Application form (анкета для моряка)

Если Вы обнаружили, что заполнять данную форму в онлайн режиме займет слишком много времени, Вы можете скачать анкету моряка с нашего сайта (требуется архиватор RAR), заполнить ее и отправить нам по e-mail (          - Поля обязательные для заполнения)


Personal data

Position applied for:
2nd choice:
You are:
Date of Birth:


*** Sequence for all documents and certificates bellow is following: Number -> Date of Issue -> Place -> Valid Until

Passports

Seaman’s Identification Card
Foreign Civil Passport
National Passport

Main certificates

Endorsement
Endorsement
Endorsement

Other certificates

Sec.A-VI/1 STCW-95 (Basic, Social responsibilities)
Sec.A-VI/2 STCW-95 (Proficiency in survival craft)
Sec.A-VI/3 STCW-95 (Advanced fire fighting)
Sec.B-V/4 & B-V/5 STCW-95 (Hazardous Cargoes)
Sec.A-VI/4-1 STCW95 (Medical first aid)
Sec.A-VI/4 STCW-95 (Medical Care)
Reg.V/1, 1.1,1.2; Sec.A-V/1, 1.7 (Oil Tankers Famil.)
Res.10 Sec.A-V/1, 9.14 (Adv.training Oil Tankers)
Reg.V/1, 1.STCW-95 (Breathing apparatus)
Res.11.12&16.34 Sec.A-V/1 (Chem Tank)
Res.11.12&16.34 Sec.A-V/1 (Liq Tank)
Res.11.12&16.34 Sec.A-V/1 (Gas Tank)
MARPOL 73/78 (Crude Oil Washing)
Res.A.741(18), MSC 104(73) (Safety Officer)
Sec.II/2 STCW-95 (Revalidation Course)
Sec.A-I/12 STCW-95 (Radar, ARPA, Search & Rescue)
Sec.A-I/12, B-I/12 STCW-95 (ECDIS)
Reg.XI-2 (Ship Security Officer)
Sec.B-II/1, B-II/2, B-VIII/2 STCW-95 (Ship Handling)
Sec.B-II/1, B-II/2, B-VIII/2 STCW-95 (Bridge Team)

Foreign licences, seamen’s books and endorsements

Last 5 Employments

*** Sequence for Last 5 Employments is following: Vessel name -> Owner -> Flag -> Rank -> From -> To -> Vessel Type -> Engine -> DWT/BHP

1
2
3
4
5

Last 3 Employers Full Style

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