You are on page 1of 2

17 Kursu str.

Liepaja, LV 3401
AJANTESS AJANTESS INTERNATIONAL Ltd. Tel: 371 63484421
Ap pl i cati on for S ea S taff E mp l oymen t Fax: 371 63484440
Form ASSE 0204 ayax@kernel.lv
NOMINATION FOR M/V:
Position applied for: Date:
Surname: First Name:
Date of Birth: Place of birth:
Nationality: Departure airport :
Home address:
Tel.:   Marital status:
Number of children under the age of 18:
Next of Kin / Relationship /Address:

Marine college:
Email @

CERTIFICATES:
Description Number Place Issue Expiry
License of Competency
G r a d e:
Endorsement
Watch keeping G r a d e:
Passport
Resident 
Seamans book
Personal survival techniques, safety and social
responsobility
Proficiency in survival craft, resque boats
Fire prevention and fire fighting
Elementary first aid
Vaccinations
Medical cert.
Chemica tanker certificate
Oil tanker certificate
Liquid Gas certificate
GOW
IGS
U.S. Visa

Languages: English  Other: fluently  good  satisfactory 

PREVIOUS SEA SERVICE:


SERVICE
From To Rank Vessel`s name / Flag Type M.E.Type / HP Company name
MM.YY MM.YY
Minnimum Salary:

You might also like