Мы гарантируем, что персональные данные, которые Вы нам сообщаете, будут использованы исключительно для целей обработки Ваших запросов. Мы работаем в соответствии с Законом Украины № 2297-VI от 01.06.2010 г. «О защите персональных данных».

* Я согласен с содержанием Соглашения.

(*) Required Fields

Position Applied for

Position: * Second Choice:
Wage (min, $):

Personal Information

First Name: *
Middle Name:
Last Name: *
Date of Birth:
Country of Birth:
Home Address:
English Language Knowledge:
E-mail: *
US Visa: exp.:
Australian Visa: exp.:

Records of Service for Last Seven Years

Ship's Name Year of Built Type DWT GRT Country (Flag) Owner/Manager Position Period from (d/m/y) till (d/m/y)

Contact details of previous Employers

Name of Ship Crewing Agency / Shipowner Tel. numbers / Address Person in Charge

Additional Information

Marital status:
Children Under the Age of 18:
Next of Kin:
Color of Hair:
Color of Eyes:
Boiler Suite Size:
Safety Shoes Size:

List of Documents

Identification Code:
National Passport: Issued: By:
Tourist Passport: Issued: exp:
Seaman's Passport AB: dtd: exp:
Other Countries Seaman's Book:
#: dtd: exp:
from (d/m/y): till (d/m/y):


Competency : Grade dtd: exp:
Endorsement: dtd: exp:
STCW'78/95 A-VI/1 (personal survival, fire prevention, elementary first aid & social responsibilities): dtd: exp:
Proficiency in Survival Craft: dtd: exp:
Advanced Fire Fighting: dtd: exp:
Ship's Medical Care: dtd: exp:
Radar Observation & Plotting: dtd: exp:
Automatic Radar Plotting Aids: dtd: exp:
GMDSS: dtd: exp:
Ship's Security Officer: dtd: exp:
Hazmat: dtd: exp:
#: dtd: exp:
#: dtd: exp:
#: dtd: exp:

Medical examination and vaccination

Yellow Fever: issue date:
Last Medical Examination: issue date:


Additional Information: