SINOSAIL MARINE SERVICES
SEAFARER'S APPLICATION FORM PHOTO
Version: General
Information provided must be true and correct!! This form prepared by:
Position Applied for: Date(DD/MM/YY):
PERSONAL INFORMATION
English Name: Date of Birth(DD/MM/YY): Marital Status:
Chinses Name: Place of Birth: Next of the Kin:
Height: Weight: Contact Number:
Contact Number: ID Number： (MM/YY-MM/YY):
Graduated College/Major: Email:
Residential Address:
CERTIFICATES
Certificates Type Number Date of Issue Date of Expiry Place of Issue
Passport
Seafarer's Passport
Cert of Competency (COC)
Seaman's Record Book
GMDSS Cert (Deck Officer Only)
Professional Training
Basic Safety Tranining
Survival Craft&Rescue Boats
Advanced Fire-fighting
Medical First Aid
Radar Observer & Simulator
Arpa Simulator
Medical Care On Board
Oil Tanker Familiairzation
Adv. Training On Tanker Operations
Chemical Tanker Familiairzation
Adv. Training Chemical Tanker
Other 1:
SERVICE RECORDS
Name of Employer
Name of Vessel
Rank
Type of Vessel
Flag
Trade Area
GRT/ DWT
BHP/KW
Date of Sign-on
Date of Sign-off
Multi-national (Y/N)
Remarks:
TEL：0532-83817719 83817702 FAX：0532-80912795 E-Mail：yangfanchuanwu@163.com
ADD：Room5023,YigaoShuma Plaza,NO.167 Liaoning Rood,Shibei Dist,Qingdao,China