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CRW 03 - Sea Staff Application Form

The document is an application for employment with a logistics company. It requests information such as personal details, certifications, sea experience, and references from applicants.

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Gigi Padilla
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© © All Rights Reserved
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50 views

CRW 03 - Sea Staff Application Form

The document is an application for employment with a logistics company. It requests information such as personal details, certifications, sea experience, and references from applicants.

Uploaded by

Gigi Padilla
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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SKEIRON Logistics Pte Ltd CRW 03

APPLICATION FOR EMPLOYMENT


POSITION APPLIED FOR : DATE AVAILABLE :

FAMILY NAME : NAME :

NATIONALITY: WEIGHT : HEIGHT :

DATE OF BIRTH : PLACE OF BIRTH : Photo

ADDRESS:

MOST CONTACTABLE NO. : EMAIL ADDRESS :

PASSPORT NO. : EXPIRY DATE :

SEAMAN'S DISCHARGE BOOK NO. : EXPIRY DATE :

NAME OF NEXT OF KIN: RELATIONSHIP:

CONTACT NO: ADDRESS:

STCW Certificates Checklist Certificate Number Training Centre Place of Issue Date of Issue Expiry date

Certificate of Competency ( CoC )

General Operator Certficate ( GMDSS )

Flag State Endorsement for Certificate of Competency

Flag State Endorsement for General Operator Certificate

Bridge / Engine Resoruce Management Certificate

Deck Ratings / Engine Ratings Wacthkeeping Certificate


(COP II/4/5 or COP III/4/5)

ETO / ETR Certificate ( III/6 / III/7 )

Basic Safety Training ( BST )

Proficiency in Survival Craft and Rescue Boat ( PSCRB )

Personal Safety & Social Responsibility ( PSSR )


Advance Fire Fighting / Fire Prevention & Fire Fighting
( AFF ) / ( FP&FF )

Medical First Aid ( MFA )

Medical Care Onboard ( MCOB )

Ship Security Officer ( SSO )

Security Training for Seafarers with Designated Security Duties


(SDSD )
Crane Certificate

Welding Certificate

Ship's Cook Certificate - MLC 2006 compliance

ECDIS

Prepared by: HSE Department Rev. 01


Approved by: CEO
1 March 2021
SKEIRON Logistics Pte Ltd CRW 03
APPLICATION FOR EMPLOYMENT
PREVIOUS SEA EXPERIENCE - Note: Sequence for entering sea service records: Latest service should be entered at row no. 1 and then older services downward.

Engine Sign On Sign Off No. of


Rank Name Of Vessel Vessel Type Flag GRT Trading area
(ex: 2X 1500KW) (dd/mm/yy) (dd/mm/yy) days
0

Prepared by: HSE Department Rev. 01


Approved by: CEO
2 March 2021

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