Xtest text
Full Name
Email
Telephone
Photograph
Father's name
Mother's name
Place of birth
Date of birth
County
Address
Marriage stateMarriedUnmarried
Name of Spouse
Num. of children
Ages of children
Tax office
VAT ident. number
Passport
Brochure
Place of issue
Date of issue
Certififate
Number
Profession
Alt. Profession
Degree/Permit
Date of review (after 5 years)
Do you have RO-RO(STCW) certififateYesNo
Date
Do you have a firefighter/rescue degreeYesNo
Do you have a ship safety certificate (ISPS)YesNo
Do you have a certificate of medical treatmentYesNo
Do you have a certificate of medical examinationYesNo
Expiration date
Other certificates
Work experience on sea
FROM
UNTILL
COMPANY
SHIP
PROFESSION
+-
Total work experience on sea:
Years:
Months:
Work experience on land:
Please enter the names of people who can recommend you. Former employers are prefered.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
I have read and agree to the terms of employment
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