AQUAMARINE CREW AGENCY

We make your excellent future

Employment Application Form For Seafarers

Full Name:
Rank:
Date of Birth:
Place of Birth:
Nationality:
Permanent Address:
Phone:
E-mail:
Civil Status:
Next of Kin:

PERSONAL DETAILS:
PHOTO
DOCUMENTS:
DOCUMENTS NUMBER ISSUED VALID COUNTRY
Travel Passport
National Seaman’ s Book
Certificate of Competency
Endorsement
GMDSS
GMDSS Endorsement
Basic Safety Training
Proficiency in Survival Craft
Advanced Fire Fighting
Medical Care
HAZMAT
ARPA/ Radar
Bridge Team Management
Engine Team Management
Ship Handling
ECDIS
Security Awareness / Duties
Ship’s Security Officer
Ship’s Safety Officer
Elec and Electronic Eng.
High Voltage Equipment
Yellow Fever
USA Visa
 AQUAMARINE CREW AGENCY
We make your excellent future

Employment Application Form For Seafarers

TANKER DOCUMENTS:
Certificate of Proficiency ( OIL)
Certificate of Proficiency ( GAS)
Certificate of Proficiency (CHEM)
Oil Tanker Certificate
Gas Tanker Certificate
Chemical Tanker Certificate
Crude Oil Washing
Inert Gas System

SEA SERVICE (starting from last employment at sea):

RANK FROM TO NAME FLAG VESSEL DWT ENGINE/ KW COMPANY
OF TYPE MODEL
VESSEL

MARINE EDUCATION HISTORY:

COURSES/COLLEGE/ACADEMY COUNTRY DIPLOMA FROM TO
NAME

ENGLISH KNOWLEDGE POOR SATISFACTORY GOOD FLUENT

MARLINS: %
CES 5.2: %
REFERENCES (last 2 employers):
NAME OF COMPANY RESPONSIBLE PERSON CONTACT DETAILS

I, … , hereby certify the authenticity of the data specified in the application form and agree to the
automatic processing of my personal data, their transfer (including cross-border) and storage for
employment purposes.
Signature of seafarer: