BIBBY SHIP MANAGEMENT

Please send photo (in jpg or gif

format)
42-A Marshala Biryuzova Str, Sevastopol, Ukraine as an attachment to the e-mail
Phone : +380 692 540403, 540909, 403852, Fax +380 692 540403
crew@ee.bibbyshipmanagement.com;
www.ee.bibbyshipmanagement.com

APPLICATION FORM
Position: Position 2: Date of readiness:
Surname: Name: Middle :
Фамилия: Имя: Отчество:
Date of Birth: Country of Birth: Citizenship:
Home Address:
Phone, Mobile, E-mail:
DOCUMENTS
Passport No: Place of Issue Date of Issue Date of Expiry
S/book No: Place of Issue Date of Issue Date of Expiry
U.S Visa C1/D Place of Issue Date of Issue Date of Expiry

Date of Date of
Description Certificate Number Issue Expiry
Place of Issue

License
Endorsement:
Endorsement is valid for: Oil tanker Chemical tanker Gas tanker
Basic Safety Training
Medical First Aid
Advanced Fire Fighting
Proficiency In Survival Craft
Medical Care
Fast Rescue Boat Leader
ROP/ARPA
G.M.D.S.S.
Manoeuvring & Ship Handling
Ship Security Officer
Ship Safety Officer
Ro-Ro Passenger Ships
Bridge Team Management
ECDIS
Oil Tanker Familiarization Course
Oil Tanker Specialized Training
Dangerous And Hazardous Substances
Chemical Tanker Specialized Training
Liquefied Gas Tanker Specialized Training
Inert Gas System
Crude Oil Washing
Ship's Crane Operator
Offshore Survival
High Voltage Certificate
BOSIET / FOET
HUET
DP Induction course
DP Advanced course
DP Full course
DP Full course (Limited)
HLO
DP Maintenance Certificate
Yellow Fever Vaccination
Other certificate:
Other certificate:
Seaman’s books and endorsements issued by other countries:
Pre-Sea Training / Nautical School / Institute / University Qualification: Year passed:
 Year Type of Engine Shipmanager Manning
Vessel Name Flag DWT HP Rank From To
Built vessel Type or Owner Agent

Minimum Salary: USD / Month Level of English: Marlins %     

Family Date of
Relation Address and Telephone Personal details
Name Surname Birth
Height, sm
Weight, kg
Color of Hair
Eyes
Shoes Size
Overall Size

Next of Kin: Marital Status:

 Additional information:
Nationalities you worked with:
Types of cargo you worked with:
Other information about yourself

REFERENCES from previous employers:

Company Name: Contact Details:
Company Name: Contact Details:
Company Name: Contact Details:

Where did you heard about our Company?: Friends: Newspaper: Bigboard: Internet: Other:

Thank you for registering your CV !

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