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Maritime Job Application Form

This document is a personal data and application form for an individual seeking employment with GESMAR SHIP SERVICES S.R.L. The form requests information such as name, date of birth, address, contact details, sea going experience, certifications, qualifications, languages, and references. Sea going experience includes details of past vessels and positions held. Certifications listed include STCW certificates, flag state endorsements, training courses, and nationalities sailed with. The applicant declares the information provided is accurate and agrees to the processing of their personal data according to regulations. Space is also included to assess the applicant's English language abilities and provide other remarks.

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Luca Claudiu-Alin
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31 views2 pages

Maritime Job Application Form

This document is a personal data and application form for an individual seeking employment with GESMAR SHIP SERVICES S.R.L. The form requests information such as name, date of birth, address, contact details, sea going experience, certifications, qualifications, languages, and references. Sea going experience includes details of past vessels and positions held. Certifications listed include STCW certificates, flag state endorsements, training courses, and nationalities sailed with. The applicant declares the information provided is accurate and agrees to the processing of their personal data according to regulations. Space is also included to assess the applicant's English language abilities and provide other remarks.

Uploaded by

Luca Claudiu-Alin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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GESMAR SHIP SERVICES S.R.L.

31, Marc Aureliu Street, Constanta, Romania


Tel +40 341.88.16.57, Fax +40 341.88.16.58
E-mail: [email protected]

Attach
photo here

PERSONAL DATA / APPLICATION FORM


Position applied for ______________

Rank _____________

Family Name:

Date Available ___________________

Wage expectation ______________

Name:

Date of birth:

Place of birth:

Home Address:
Home phone:

Marital status:

Height:
Weight:

Mobile

Next of kin and relationship:


Next of kins address:
Seaman's book No:
Passport

Children:
Next of kin tel:
Issued:
Issued:

Valid:
Valid:

Place of issue:
Place of issue:

SEA GOING EXPERIENCE

( MOST RECENT VESSEL FIRST )

Name of vessel

Year
built

Owner / Ship Manager /


Crewing Agency

Flag

Type of
vessel

GRT /
TEUS

Type of main
engine

KW

Rank

From
DD.MM.YY

To
DD.MM.YY

STCW Certificates
Number

Issued

Valid

Place of issue

Certificate of competency
Endorsement
Personal survival techniques

PSSR
Basic fire fighting
Advanced fire fighting
Prof. in survival craft
Medical first aid / care
Elementary first aid
Hazardous cargoes
Prev Pollution Marpol
Maritime English
Yellow Fever
Other Flag States
Seamens Books

Number

Issued

Valid

Place of issue

GMDSS
GOC
Radar ARPA
Ship Security officer
Bridge Team Managm
Engine Team Managm
RoRo passenger
ECDIS
Training Oil tankers
Training Chemical tk
Training for LPG tk
Tanker familiarization
US Visa
Rank

Document No

Issued

Valid

Other Flag States Cert. of


competency

Rank

Document No

Issued

Valid

Nationalities of staff sailed with


Foreign Languages: .
Last wages: .
Please complete addresses of your previous employers for references
Company
Address

Tel

Tel

By signing this application form I declare that all information provided above is true and accurate to my best knowledge and belief and I agree to the processing of my personal data
by GSS SRL and its partners in accordance with applicable data protection regulation (ANSCDP 16231)
Signature____________________

Date ________________

=================================================================================================================================
==
English abilities:
Beginner o
Elementary o
Lower Intermediate o
Intermediate o
Upper Intermediate o
Advanced o

Other remarks:

...........................................................................................................................................................................................................
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