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Анкета моряка
Contacts data
Position:
First Name:
Last Name:
Father's Name:
Email:
Phone:
About myself
Citizenship:
Date of birth:
Place of birth:
Adress:
Marital staus:
Num of children:
Relation:
Next kin:
Next kin adress:
Next kin name:
Maritime education received
Name of school/Academy:
From:
Till:
Type of degree received:
Documents
Seaman's password:
Num. doc:
Place of issue:
Date of issue/validity:
Travel password:
Num. doc:
Place of issue:
Date of issue/validity:
Other S/B:
Num. doc:
Place of issue:
Date of issue/validity:
Shengen visa:
Num. doc:
Place of issue:
Date of issue/validity:
STCW
Cert. of Competency:
Grade:
Num:
Place of issue:
Date of issue/validity:
Endorsement:
Grade:
Num:
Place of issue:
Date of issue/validity:
Cert. of Competency (2):
Grade:
Num:
Place of issue:
Date of issue/validity:
Endorsement (2):
Grade:
Num:
Place of issue:
Date of issue/validity:
Basic safety training:
Num:
Place of issue:
Date of issue/validity:
Medical first aid on board ship/ medical care:
Num:
Place of issue:
Date of issue/validity:
Proficiency in survival craft:
Num:
Place of issue:
Date of issue/validity:
Advanced fire fighting:
Num:
Place of issue:
Date of issue/validity:
Dangerous and hazardous cargoes:
Num:
Place of issue:
Date of issue/validity:
Radar observer &plotting/a.r.p.a.:
Num:
Place of issue:
Date of issue/validity:
Maintenance of electrical and
electronic engineering:
Num:
Place of issue:
Date of issue/validity:
Bridge team management:
Num:
Place of issue:
Date of issue/validity:
Ship handling arrangements:
Num:
Place of issue:
Date of issue/validity:
Ship security officer (isps):
Num:
Place of issue:
Date of issue/validity:
Ships safety officer (ism):
Num:
Place of issue:
Date of issue/validity:
Trainig of seafares with
designated security dues:
Num:
Place of issue:
Date of issue/validity:
Tanker familiarization:
Num:
Place of issue:
Date of issue/validity:
Oil tankers specialized training:
Num:
Place of issue:
Date of issue/validity:
Gas tankers specialized training:
Num:
Place of issue:
Date of issue/validity:
Chem. Tankers specialized training:
Num:
Place of issue:
Date of issue/validity:
Crude oil washing of oil tank:
Num:
Place of issue:
Date of issue/validity:
Inert gas system:
Num:
Place of issue:
Date of issue/validity:
Ecdis:
Num:
Place of issue:
Date of issue/validity:
Physical fitness
Medical examination certificate:
Num:
Place of issue:
Date of issue/validity:
Yellow fever vaccination:
Num:
Place of issue:
Date of issue/validity:
Drug & alcohol test:
Num:
Place of issue:
Date of issue/validity:
Previous sea service (last 5 years):
Vessel name:
Company:
Flag:
Vessel type:
Engine type:
KWT:
Rank:
From:
To:
Sizen
Clothes:
Shoes:
Height:
Weight:
Notes
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