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SEAFARER'S APPLICATION FORM - Page 1 of 4 - PERSONAL DATA
(FORMULAR DE APLICARE PENTRU PERSONAL NAVIGANT-PAGINA 1 DIN 3 DATE
PERSONALE)
PERSONAL INFORMATION ( DATE PERSONALE)
Family Name (Nume)
Nearest Airport
(Cel mai apropiat
ADDRESS (include telephone country & area codes, advise also secondary or contact addresses if any)
ADRESA (incluzand nr telefon, ara si cod zona, a doua adres sau adresa de contact , dac este cazul )
Street & Nr. (Strad si
Email Address (Adresa
Numr)
Email)
Location (Localitate)
Mobile Phone (Tel mobil)
City (Ora)
Fax (Fax)
NEXT OF KIN INFORMATION (person to contact in case of emergency & insurance beneficiary)
RUDA CEA MAI APROPIAT/ MPUTERNICIT ( persona de contact n caz de urgen i beneficiarul
Family Name (Nume)
First Name(s) (Prenume)
Nationality
(Naionalitate)
Street & Nr. (Str. si Nr.)
Location (Localitate)
Relationship (Grad de
rudenie)
Email Address (Adresa
email )
Mobile Phone (Tel mobil)
City (Ora)
Fax (Fax)
REMARKS(REMARCI)
Requested Rank(s)
(Funcie)
Prefer Vessel Types (Tip
de nav preferat)
Employment Preference
Availability Date
(Disponibil din)
Minimum Salary(Salariu
minim)
Constanta Branch, Romania, 3rd Cristea Georgescu Street, 1st Floor, Int.04, Open every day 10am-6pm
T/F (004) 0733 183 933 - office@marinacrewing.com - Skype - marina.crewing - Facebook - LinkedIn - www.marinacrewing.com
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I hereby affirm that all the information provided by me in this application is true and correct to the best of
my knowledge.
Prin prezenta confirm c toate informaiile date de ctre mine n aceast formular de aplicare sunt adevrate
i corecte.
Exp. Date
Data
expirrii
Constanta Branch, Romania, 3rd Cristea Georgescu Street, 1st Floor, Int.04, Open every day 10am-6pm
T/F (004) 0733 183 933 - office@marinacrewing.com - Skype - marina.crewing - Facebook - LinkedIn - www.marinacrewing.com
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Constanta Branch, Romania, 3rd Cristea Georgescu Street, 1st Floor, Int.04, Open every day 10am-6pm
T/F (004) 0733 183 933 - office@marinacrewing.com - Skype - marina.crewing - Facebook - LinkedIn - www.marinacrewing.com
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Please indicate your sea service in the last 10 years as exactly as possible - required are the actual sign-on and sign-off dates according to the service
certificates resp. seaman's book entries. To speed up processing kindly indicate phone and/or fax numbers of your previous employers. Ship sizes are to be
indicated in gross tons, total engine output in kilo Watt (1 kW = 1.34 bhp) to go along with STCW limitations. Please attach evidence for the listed sea service
(copies of seaman's book entries, service certificates etc.). The information provided may be passed on to our clients and to flag state administrations to allow
for verification of rank experience. Please use the European date format (DD.MM.YY).
SEAFARER'S APPLICATION FORM - Page 3 of 3 - SEA SERVICE (LAST 10 YEARS)
Family Name(Nume):
Vessel's Name
(Numele Navei)
Flag
GT
(GRT)
(Pavilion)
First Name(s)
(Prenume):
kW
Ship Type
(Kw)
(Tipul
Navei)
Eng.Maker
(Motor
Principal)
Rank
(Funcie)
S/On Date
(Data
ambarcrii)
Date of
Birth(Data
S/Off Date
Employer (company to
(Data debarcrii) contact for reference)
(Angajator)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10
.
11
.
12
.
13
.
14
.
15
.
Date
Data:
Signature
Semntura:
Constanta Branch, Romania, 3rd Cristea Georgescu Street, 1st Floor, Int.04, Open every day 10am-6pm
T/F (004) 0733 183 933 - office@marinacrewing.com - Skype - marina.crewing - Facebook - LinkedIn - www.marinacrewing.com
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Constanta Branch, Romania, 3rd Cristea Georgescu Street, 1st Floor, Int.04, Open every day 10am-6pm
T/F (004) 0733 183 933 - office@marinacrewing.com - Skype - marina.crewing - Facebook - LinkedIn - www.marinacrewing.com
Explore marinacrewing.com