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CHINA MARINE & SEAMEN SERVICE CORPORATION
SEAFARER'S APPLICATION FORM
1.PERSONAL PARTICULARS
English Name * Date of Birth * Name of Spouse
Chinese Name * Place of Birth * Type of Blood *
Position Spplied * Hight/Weight * Shoes Size(Yard) *
ID No. * Contact Phone *
Address * Post Code *
2.MARINE COLLEGE/SCHOOL ATTENDED
Nme of School Speciality Year of Graduation Type of Diploma held
3.CERTIFICATES
Category Capacity Number Date of Issue Date of Expiry Issuing Authority
C.O.C. * * * * *
GMDSS * * * *
Seafarer's Passport * * * *
Passport * * * *
Discharge Book
Familiarization and Basic Safety Training * *
Proficiency in Survival Craft and Rescue Boats
Advanced Fire-fighting Training
Proficiency in Medical First Aid
Medical Care On Board(Master & C/O only)
Radar Observation and Plotting and radar simulator
ARPA Simulator
Oil Tanker Familiarization
Advanced Training on Oil Tanker Operations
Advanced Training on IGS and COW
SSO cert
4.SEA SERVICE
Name of Company * * * * *
Name of Vessel * * * * *
Type of Vessel/GRT * * * * *
Type of M.E./BHP * * * * *
Flag * * * * *
Trading Area * * * * *
Rank * * * * *
Date of Sign-on * * * * *
Date of Sign-off * * * * *
Personal E-mail
Personal Remarks

 

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