Seafarers application form

We are recruitlng
Position Applied for:
    ____________
Name
    ____________
Nationality
    ____________
Gender
male
female
Date of Birth
    ____________
Contact Number
    ____________
E-mail
    ____________
Height
    ____________
Weight
    ____________
passport number
    ____________
Seafarer's passport number
    ____________
Cert of competency number
    ____________
Seaman's Record Book
    ____________
Basic Safety
yes
no
Craft and Rescue Boat
yes
no
Medical Tirst Aid
yes
no
Adv. Fire-Fighting
yes
no
Medical Fist Aid
yes
no
Oil and Chemical Famillairzation
yes
no
Oil Tanker Operation
yes
no
Chemical Tanker Operation
yes
no
seafares with designated security duties
yes
no
security awareness training
yes
no
particulars of services in last 5 years
    ____________
Your earliest sailling time
    ____________

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