CANDIDATE NAME (as appears on passport)

Passport valid Until:

Passport Number:
Email Address:
Phone Number:
Home Address:
Position Applying For:

Candidate Nationality (must possess a valid passport):

Candidate Point of Origin (or Residence country if not the same as Nationality):

Experience Summary (Please describe a summary of your experience in the text box below)

WORK EXPERIENCE (list most recent first)

Company Name (insert the name in Position Held (insert the position Service Period (from Month/Year to Month/Year)
this cell) in this cell) (insert the period in this cell - example 02/2017 to
01/2019)

Rig Name, Type & Design (insert the Client (insert the name of the Country of Assignment (insert the country of
rig name, type and design in this cell client in this cell) assignment in this cell)
- example: Rig 1, Drillship, 6th
Generation)
Details of Experience (provide all details about the work you performed in this company)

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience

Company Name Position Held Service Period (from Month/Year to Month/Year)

Rig Name, Type & Design Client Country of Assignment

Details of Experience
EDUCATION
University or College Degree / Diploma:
Institution Name / Date received:

If no university or college degree, list highest education level attained:

Technical School:
Institution Name / Date Received:

TRAINING & LICENSES (list all valid trainings and STCW licenses relevant to position being applied for)
Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

Training or License name: Training School: Expiry Date:

OTHER QUALIFICATIONS
Languages /
Leadership
courses
etc. /
References Name: Position: Company: Contact
Information:

Name: Position: Company: Contact

Information: