Scribd
Upload
215 views8 pages

Application TSM

This document appears to be an application form for employment at a ship management company. It requests personal information such as name, date of birth, citizenship, contact details, education history, sea service experience aboard various vessels, certifications and qualifications held. It also asks for references from previous employers and additional details like languages spoken, marital status and how the applicant heard about the company. The final page relates to offshore experience for dynamic positioning ranked positions.

Uploaded by

Niebuhr D'silva
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
215 views8 pages

Application TSM

This document appears to be an application form for employment at a ship management company. It requests personal information such as name, date of birth, citizenship, contact details, education history, sea service experience aboard various vessels, certifications and qualifications held. It also asks for references from previous employers and additional details like languages spoken, marital status and how the applicant heard about the company. The final page relates to offshore experience for dynamic positioning ranked positions.

Uploaded by

Niebuhr D'silva
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd

GENERAL INFO

APPLICATION FORM

TOTAL SHIP MANAGEMENT


Tel: +38 094 712 40 85 / Mob: +38 095 22 44 001 , +38 098 800 2 444
65045, 33 Zhukovskogo Street, 4th floor, Please send your photo separatel
office 412, Odessa, Ukraine JPG format
Email: cv@[Link] [Link]

Rank 1: Rank 2: Minimum Salary:


Surname: Name: Father's name:
Фамилия: Имя: Отчество:
Date of Birth: Place of Birth: Citizenship:
Home Address: Readiness:
Phone, Mobile: E-mail:
DOCUMENTS
Identity Documents Number Place of issue Issued on
Travel Passport:
Seaman’s Book:
National Licenses Capacity
Diploma:
Endorsement:
Endorsement is valid for: Oil tanker Chemical tanker Gas tanker
VISAS & ENDORSEMENTS
Identity Documents Issued on Expiry date
US Visa C1/D
US Visa B1 OCS
Schengen Visa
Mexican Visa
Brazilian Visa
Dutch Endorsement
UK CEC Endorsement
Norwegian Endorsement

List of Certificates Cert No Place of issue Issued on

Basic Safety Training


Medical First Aid
Medical Care
Advanced Fire Fighting
Proficiency In Survival Craft
Fast Rescue Boat Leader
ROP/ARPA
ECDIS
G.M.D.S.S.
Manoeuvring & Ship Handling
Ship Security Officer
DP Induction course
DP Advanced course
DP Full course
DP Full course (Limited)
Ro-Ro Passenger Ships
Passenger ships other Ro-Ro
Oil Tanker Familiarization Course

Страница 1
GENERAL INFO
Oil Tanker Specialized Training
Dangerous And Hazardous Substances
Chemical Tanker Specialized Training
Liquefied Gas Tanker Specialized Training
Inert Gas System
Crude Oil Washing
Ship Safety Officer
HUET
Maintenance of electrical and electronic equipment
Bridge Team Management
BOSIET / FOET
High Voltage Certificate
HLO
DP Maintenance Certificate
Offshore Survival
Ship's Crane Operator
Yellow Fever Vaccination
Other certificate:
Other certificate:
Other certificate:
DOCUMENTS ISSUED BY OTHER COUNTRIES:

Education (University, Marine College, etc.) Qualification: Year passed:

Please go to Sea Service page

Страница 2
GENERAL INFO
V 2.1
APPLICATION FORM

Please send your photo separately in


JPG format

Expiry date

Expiry date

Issued on Expiry date

Страница 3
GENERAL INFO

Year passed:

Страница 4
SEA SERVICE
SEA SERVICE (starting from the last contract)
Year Type of Gross Sign on Sign off
Name of vessel Flag DWT Engine BHP KW Rank Shipping Comp
Built vessel tonnage Date Date

REFERENCES: Next
Relationship Surname, Name DOB A
(Please indicate name&contact details of your current and two previous employers) of kin
Name of the Company / Contact Person:
Email ( No.
Name of the Company / Contact Person:
Email ( No.
Name of the Company / Contact Person:
Email ( No.

ADDITIONAL INFORMATION: PERSONAL DETAILS:


Nationalities you worked with: Height, cm: Weight, kg:
Types of cargo you worked with (for tankers ) Color of Hair: Eyes:
Other certificates: Shoes size: Overall size:

Страница 5
SEA SERVICE
Level of English : Marlins Score: Marital status

Where did you hear about our company? Friends: Newspaper: Internet: Other:

Please send your CV to cv@[Link]. Thank you!

Страница 6
SEA SERVICE

Crewing OFFSHORE FLEET ONLY


Shipping Company
Company DP rank DP system

Address/Tel number

Страница 7
SEA SERVICE

Страница 8

You might also like