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EMPLOYMENT APPLICATION FOR SHIP PERSONNEL

OFC-007 (01-14)

PHOTO
APPLICATION FOR EMPLOYMENT AS (RANK): DATE AVAILABLE FOR JOINING

Personal and Next of Kin Details


Instructions For Completion:
Must be completed by all seafarers BEFORE joining.
Surname:

Given Name:

Date of Birth :
Nationality

Alias:

Age:

Place of Birth:

Weight:

Height:

Marital Status: Single / Married / Divorced

Telephone:

Address:

Mobile Ph.:

Fax:

E-Mail:

Nearest International Airport:

Passport No.:

Issued At:

Expiry Date:

Seaman Bk. No.:

Issued At:

Expiry Date:

Next of Kin
Address:

Relationship:

Date of Birth:

Telephone:

No. of Dependents
Relationship

Full Name

Date of Birth

2.

3.

4.

1.

Page 1 of 6

OFC-007 (01-14)

Document

Lege

Rank

nd

1.

2.

3.

4.

5.

6.

Nat.License
(Circle
applicable)
National
License
Endorsement
Ships Flag
Endorsement

Watchkeeping
(Ratings National)
GMDSS GOC
(National or
Others)
Large Ship
Handling(Maste
rs & Chief
Officers)
BTM

LIC

LIC

FLG

WKR

GMD1

Regn
STCW95/2010
Deck

Engin
e

II/1

III/1

II/2

III/2

A-I/2

A-I/2, A-I/10

II/4

A-IV/2

LSH

7.

8.

ECDIS(Deck
Officers)

Doc.
No.

Issue Issue
Date Place

Expiry
Date

STCW Regulation
I/14 and Manila
2010 Amendments

9.

10.

11.

12.

13.

14.
15.
16.
17.
18.
19.

High Voltage
(Electric
Engineers)
B&W ME Course
(Senior
Engineers)
Class
Certificate
(Fitter Only)
Proficiency
in Survival
Craft
Personal
Survival
Techniques
Advanced
Fire
Fighting
Basic Fire
Fighting
Medical
Care
Medical
First Aid
Elementary
First Aid
Pers. Safety
/Social
Responsibility

PSC

A-VI/2-1

PST

A-VI/1-1

AFF

A-VI/3

BFF

A-VI/1-2

MED

A-VI/4-2

MFA

A-VI/4-1

A-VI/1-3

A-VI/1-4

EFA
PSS

Page 2 of 6

OFC-007 (01-14)
Ship Security
20. Officer
Certificate
Proficiency
Designated
21. Security
Duties
Hazardous
Materials
22. (HAZMAT)

23.
24.
25.

26.
27.
28.

SSO

AS PER STCW
2010

PSD

AS PER STCW
2010

49 CFR

HAZ

(U.S. Traders
Only)

Chief cook
National
License (COC)
Pre-Joining
Medicals
Physical
Examination
Report
Vaccination(Ye
llow
Fever)

AS PER STCW
2010
PJM
OFC
MLC 2006

012
VAC

Passport

PP

Seamans Book
(Nat)

SB1

SB2

Seamans
29. Book (Flag)

U.S. Visa
30. (C1/D)
31.

Other visa

32.

Other visa

ADDITIONAL PROFESSIONAL QUALIFICATION (WORKSHOP/NAUTICAL COLLEGE)


Establishment Name

Date Attended

BASIC & ACADEMIC QUALIFICATIONS

DATE PASSED

ADDITIONAL INFORMATION

(for Deck/Eng. Officers)

(Please Specify Experience on special vessel types as tanker, Reefer, PCC


etc. or machinery as IGS/COW, Refrigeration Plant, Automation etc.)

Page 3 of 6

OFC-007 (01-14)
References and recommendations
(Please specify and attach Reference letters and recommendations, from previous
Employers)

Yes/ Not Available

Employer

Letter Dated

Employer

Letter Dated

SUMMARY OF EXPERIENCES
Experience as / on
Container
P.C.C.
G.C.
Reefer
B.C.
Tanker
Total

Master
C/E

C/O
1/Ass Eng

2/O
2/Ass Eng

3/O
3/Ass Eng

E/E

Total
ENGINEER APPLICANT
NAVIGATING APPLICANT

SULZER RTA
CONTAINER SHIP

SULZER RLB, RND


P.C.C.

MAN B&W MC
GENERAL CARGO SHIP

MAN B&W ME
REEFER

MITSUBISHI
BULK CARRIER

SEMT PIELSTICK
TANKER

OTHERS
OTHERS
Geared vessel
Geared vessel

(type )
Offshore supply

(type )
OffShore supply

vessel

Vessel

(type )

(type )

WEATHER AGREEABLE TO ACCEPT ONE RANK LOWER


WEATHER AGREEABLE TO JOIN VESSEL TRADING IN WAR ZONE
NAME:

RANK APPLIED FOR:

______________________________________

Date

SIGNATURE

Page 4 of 6

OFC-007 (01-14)
* Deck Officers/ Ratings
** Engine Officers/Ratings

DETAILS OF PREVIOUS SEA SERVICE (LAST 10 YEARS Start with Last Vessel)
Name of Vessel

Flag

Vessel

DWT

Type

Deck

**

Engine

Rank

Period of

Duration

Service

Cont - TEU
Maker,
PCC Units

From

Model &

To

D
Name of Operators

Bulk Type
Power/KW
Tanker - type

Page 5 of 6

OFC-007 (01-14)
FOR OFFICIAL USE ONLY (MANNING AGENT / HEAD OFFICE)
For Rank:

Name of Person Interviewed:

Method of Interview(i.e.Personal/

Telephone/Video call by Skype


etc):

Interview date:
Interviewers Name:
1
English Language Ability
Read
YES
/ NO
2
General Impression
V.Good
Good
3

Computer Knowledge (Officers)

Safety / Emergency Procedures

I S M

Awareness (Officers)

Position:
Write
YES
/ NO
Average

Below Avg.

V.Good

Good

Average

Below Avg.

V.Good

Good

Average

Below Avg.

V.Good

Good

Average

Below Avg.

Courses Attended
6

Watch Keeping Procedures

Maintenance

Collision Regulations (Deck Off.)

Stability (Deck Off.)

10
11

Automation (Engineers & E/E)


Machinery Knowledge (Eng.)

12
13
14

Reefer Knowledge / Experience


Tanker Knowledge / Experience
Worked with multi national crew
If yes, state Nationalities : Greek

Communicate
YES
/ NO

YES

/ NO

V.Good

Good

Average

Below Avg.

V.Good

Good

Average

Below Avg.

V.Good

Good

Average

Below Avg.

V.Good

Good

Average

Below Avg.

V.Good
V.Good
V.Good
V.Good
YES

Good
Good
Good
Good

Average
Average
Average
Average

Below
Below
Below
Below

NO

, Pilipino

, Italian

, Croatian

Other
15

Previous Operator's Contacts: (State Tel/Fax/Email/PIC as available)


a.
b.
c.
d.
OTHER

RESULT:

SELECTED

REJECTED

CREW DEPARTMENT: HEAD OFFICE


RESULT:

SELECTED

Original:
Copy:

Crew Dept./ Personal File


Manning Agent

Page 6 of 6

Avg.
Avg.
Avg.
Avg.

REJECTED

, Indian