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Name: Age:

Position applied for:

Previous experience in applied position, years/ months:
Total sailing experience in years/ months: Reefer vessel experience:
Experience from
other vessels
types and years/ months:

General cargoes:

Reefer Cargo carried:

Bananas Citrus Pineapples Kiwi Grapes Apples Vegetables Meat/Fish

Charterers worked for:

Dole Chiquita Del Monte Fyfes Laritzen Cool LSC Blasco Lomar Zodiac

General Questions: Yes No N/A

Are you aware of Green Reefers and its background ?
Have you visited the Green Reefer home page on internet ?
Have you sailed with any officers from the Green Reefer fleet before ?
If yes, who:
Have you had any ITF exposure last 5 years ?
Are you aware of and accepting Green Reefers No Alcohol Policy?
Is there any references or testimonials
available from last previous employers ?

Name the last 3 previous companies worked for

and number of years/ months employed.

Explain the reason for applying new position

in Green Reefers:

Deck & Engine OFFICERS:

Have you carried any USDA cargoes from where and to which port:

Are you familiar with USDA Ice Test and control procedures:

Experience from Derricks and/ or Cranes

Have you experience in working on Computer Based

Maintenance system onboard and which type of system ?

Computer based purchasing experience ?

Do you have any Flag state endorsements from previous employment

Do you have any crew to join with you or to recommend:

Main Engines types mostly worked with before: Slow speed: Medium speed:
Name on engines types worked with before:

How do you consider your general knowledge and

skills in handling reefer systems ?
Is it very good/ satisfactory/ poor:

Have you sailed without reefer engineer

on previous vessels ?
If yes,
When, for how long and type of reefer system:
Have you experience from sailing without an electrician onboard and
if yes from which vessels and for how long ?
Do you have training and experience in electrical and gas welding & cutting ?
Can you do a normal welding job onboard if necessary on a vessel without fitter.
Have you sailed on vessels practising UMS ?

Have you been participating in any special training

by manufacturer of engines, turbocharger, purifiers etc.
If yes, explain where and when:
Have you had previous approval by any Class Society
for machinery Onboard-Class by CE:

Deck Officers:
Do you have special experience from coastal
navigation and if yes, from where ?
Are yourself familiar in manoeuvring vessels in
and out of harbour, to and from the pier
Do you have special experience with tuna fish cargo
Have you ever been involved in grounding a vessel
or making damages during manoeuvring

Reference from previous company:

Very good: Good: Acceptable: Unacceptable:
Professional appearance:
Very good: Good: Acceptable: Unacceptable:
Very good: Good: Acceptable: Unacceptable:
Acceptable Unacceptable
References checked and confirmed:
Yes: No:
Yes: No:
Form completed by: Date: