PART I : personal data

Fields marked with (*) are mandatory !

* Your Rank CNP

* Surname (Nume) * Name (Prenume) Father`s name * Permanent address * City
Nationality * Date of birth Place of birth * Phone * Phone 2 (Mobile)
Next of Kin (NOK) Name Surename NOK Phone NOK Relationship * Email Children

Document Number Issued Place Valid until
Passport
Seaman`s book

PART II : certificates / courses / Highest Competency certificate held

Issuing authority Grade / Level Certificate No. Date of issue Validity
National Certificate of Competency
STCW 95/ Endorsement

Certificates Place issued Number Date issued Valid until
LIQ. GAS TANKERS
OIL TANKERS
CHEMICAL TANKERS
TANK FAMILIARIZATION
RO-RO PASSENGER SHIPS/PASSENGER SHIPS OTHER THAN RO-RO PASSENGER SHIPS A-V/2;A-V/3
PROFICIENCY IN FAST RESCUE BOATS A VI/2
SHIP SECURITY OFFICER

COURSES / STCW-95 CODE Place issued Number Date issued Valid until
TRANSPORT AND HANDLING OF DANGEROUS, HAZARDOUS AND HARMFUL CARGOES A-II/1,A-II/2,A-III/1,A-III/2
MARITIME ENGLISH A-III/1;A-III/2
PREVENTION OF POLLUTION OF THE MARINE ENVIRONMENT-MARPOL73/78- A-II/1,A-II/2,A-III/1,A-III/2
PROFICIENCY IN SURVIVAL CRAFT AND RESCUE BOATS, OTHER THAN FAST RESCUE BOATS A-VI/2,1-4
ADVANCED FIRE-FIGHTING A-VI/3
PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES ON BOARD SHIPS A-VI/1;2.1.1.4
PERSONAL SURVIVAL TECHNIQUES A-VI/1,2.1.1.1
MEDICAL CARE A-VI/4;4-6
RO-RO PASSENGER SHIPS/PASSENGER SHIPS OTHER THAN RO-RO PASSENGER SHIPS A-V/2;A-V/3
PROFICIENCY IN FAST RESCUE BOATS A VI/2
BRIDGE TEAM AND RESOURCE MANAGEMENT A-VIII,B-VIII
RADAR NAVIGATION,RADAR PLOTTING AND USE OF ARPA operational level A-I/12,A-II/1
RADAR ARPA,BRIDGE TEAMWORK AND SEARCH AND RESCUE-management level A-I/12,A-II/2
GENERAL OPERATOR FOR GMDSS(GOC) COURSE A-IV/2
GMDSS A-IV/2
SHIP SECURITY OFFICER A-VI/5
ENGINE TEAM AND RESOURCE MANAGEMENT A-III/2
ELECTRONIC CHART DISPLAY AND INFORMATION SYSTEM A-II/1; A-II/2
SHIP HANDLING AND MANEUVERING SYSTEM A-II/1
TRANSPORT AND HANDLING OF DANGEROUS, HAZARDOUS AND HARMFUL CARGOES A-II/4,A-III/4
MARITIME ENGLISH LANGUAGE TRAINING PHRASE VOCABULARY A-III/4
PREVENTION OF MARINE POLLUTION FROM SHIPS A-II/4,A-III/4
PROFICIENCY IN SURVIVAL CRAFT AND RESCUE BOATS, OTHER THAN FAST RESCUE BOATS A-VI/2,1-4
BASIC FIRE-FIGHTING A-VI/1-2
PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES ON BOARD SHIPS A-VI/1-2
PERSONAL SURVIVAL TECHNIQUES A-VI/1-2
ELEMENTARY FIRST AID A-VI/1-2
TANK FAMILIARIZATION /A-V/1; 1-7
ADV. OIL TANKER/ A-V/1;8-14
ADV.CHEMICAL TANKER/A-V/1;15-21
ADV. GAS TANKER/ A-V;22-34


PART III : Sea Experience / Last 5 years - Most recent experience on top line

Company
Vessel
Type
DWT
HP
Main Engine
Rank
Date from
Date to
Reason

TYPE: OIL/TK (OIL TANKER),  CH/TK (CHEMICAL TANKER),  LPG/TK (LPG TANKER),  LNG/TK (LNG TANKER),  RO (RO-RO),  PAS (PASSAGER),  BK (BULK),  FERRY (FERRY),  GC (GENERAL CARGO),  CON (CONTAINER),  SUPPLY (SUPPLY VESSEL),  OH (OFF SHORE),  FPSO (FPSO),  AHTS (ANCHOR HANDLING),  TUG (CRANE BARGE) 

REASON: EOC (End Of Contract),  SS (Ship Sold),  COM (Change Of Management),  MEDICAL (Medical Reasons) 

REFFERENCE CONTACT DETAILS / this part is optional.

Company Name
Address
Phone No.
Fax / E-mail
Contact Person

Notes to sea experience

Deck officers & Pumpman:

A. Indicate type of cargoes loaded:

B. Where you loading different cargoes simultaneously?

C. Which kind of pumps you have been experienced with?

Enginers:

A. Please state if you have been sailing with UMS and which remote control systems are familiar to you:


PART IV : general

A. Have you ever been denied for a foreign visa?

B. Have you been the subject of a court of inquiry or involved in a marine accident?

Nearest airport:

Your Height (CM):

Your Eyes Color:

Your Weight (KG):

Your Shoes Size:

Required Data

English
French
Italian
Spanish
German
Other

Desired salary Currency IBAN Available starting from

PART V : upload scanned documents / this part is optional. (Flash plugin required)