APPLICATION FOR EMPLOYMENT

RECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

Rank: First Name: Last Name:

Citizenship:
Date & Place of Birth: Marital Status:
Present Address: Next of Kin:
Tel:
Name /
Fax: Relationship:

Email: Address:
Educational History: Present/Last Employer:
Languages: Address:
Medical Certificate Issued: Expired: Tel:
American Visa Issued: Expired: Height/Weight Hair/Eyes:
Position Applied: Service Availability:

Licence

Licence Country Grade of Licence Number Place & Date Issued Date Expired

Passport

Number Place & Date Issued Date Expired

Seaman’s Book

Country Place & Date Issued Number Date Expired

Previous Sea Experience ( For Last Five Years or Last 10 Ships Served )

Vessel’s Name Flag DWT or Vessel Type Company Name Rank Period: From-To
Engine/kw

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Orion Marine Ltd., Uvala baluni 9 , 21000 Split, Croatia Tel: +385 21 483 693/317 386 Fax: +385 21 483 694 E-mail: orion@orionmarine.hr
 APPLICATION FOR EMPLOYMENT
RECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

Certificates

Certificates STCW Licence No. Place & Date Issued Date Expired

Page: 2 of 2
Orion Marine Ltd., Uvala baluni 9 , 21000 Split, Croatia Tel: +385 21 483 693/317 386 Fax: +385 21 483 694 E-mail: orion@orionmarine.hr
Orion Marine Ltd. d.o.o.

Uvala Baluni 9

21000 Split, Croatia

Consent form for processing personal data

Welcome to the process of recruitment of maritime crew by foreign employer, conducted by Orion
Marine Ltd. d.o.o., who provides free of charge recruitment services for maritime crew seeking
employment on foreign ships.

In accordance with EU’s General Data Protection Regulation (GDPR), all personal data needed for
recruitment process and employment, will be managed and transferred in our data base.

As required by GDPR, I hereby consent to have my personal data stored and processed by Orion
Marine Ltd. d.o.o., Uvala baluni 9, 21000 Split, Croatia for the purposes of all present and future
recruitment and intermediary services. I also consent that my personal data stored in Orion Marine
Ltd. d.o.o. data base, are made available to foreign employers/third parties with whom Orion Marine
Ltd. d.o.o. will seek my employment. I am aware and well informed of the right to withdraw my data
at any time.

………………………………………………………………….

Date, Name and Surname, Signature

Orion Marine Ltd. d.o.o. protects the personal information of the maritime crew according to the
requirements of the existing law. (Zakon o zaštiti osobnih podataka, NN 106/12)

Personal data will be stored and processed for the purposes of present and future recruitment by
foreign employers. Personal data will be transferred to foreign employers cooperating with Orion
Marine Ltd. d.o.o. All personal information are provided to Orion Marine Ltd. d.o.o. voluntarily and
data subject shall have the right to withdraw his or her consent at any time.