SINGHAI MARINE SERVICES
SY FiBFSES
SEAFARER’S APPLICATION FORM
MA BR
‘Ths apoleation form serves to provide with i information oF the Applicant and wil be teated ar personal record should the Aspicant be
employed. AFL IATEHAAG SARE. MAMEAIABI IT AEB AI
‘Aopicant is required to complete all pars in BLOCK CAPITALS, Copies ofall corificates, Seaman's book, passport and appraisal from the
‘previous companies (if any) are tobe atached. BHR ATER AS 7 IAS HH LUT eT As LE ERAN
‘oplcan st beat least 38 years of ame foray postion appli. FEE AONERDIRATT LU) 18
| POSITION APPLIED FOR: - | Date:
‘FiIR% CHIEF COOK Hii: 11/08/2023
PERSONAL DETAILS TARE Sas
‘Surmame & ‘Middle Name | LastName % Nationality [5%
SuAMSOL BArARIN STALE MALAYSIN
| Date of Birth 11171110) Place of Birth ii‘ ii Religion 5 ‘Age Fe | Af
(aes ROAR COMPOR MusuM 50 Cobur
| Height/weight ‘Safety Shoe Size Overall Size Marital Status ae
(ieee eee Seas See ht
17cm Fr ox Divorce
Passport Number Tesuing Authority ‘Date of Tesue | Date of Expiry
FS RK SRAM SAME
ASAS971 Wancsa HASU "avesy20z 1/09/2006
‘Seaman's Book Number Issuing Authority ‘Datectissue | Dateof Exmiry | COC Grade
HS BRK BRAM EEL AEE
‘SM6717 PORT KLANG 16/11/2012
Mobile Phone Number House Telephone Number | Email Address Hometown Airport
FS EGE |
6014257344 Beyarsoi21@gmelicom | na uma
ry | ed