GENERAL APPLICATION FORM - DOC - DOC

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					                                                             GENERAL APPLICATION FORM
                                                       See Terms and Conditions for Seafarers before applying.
                                                       Information you provide with this application is absolutely
                                                       confidential and will be only disclosed to the potential
              Professionals anytime, anywhere .        employer upon your agreement.
www.maritimecrewingofvancouver.com                        e-mail: info@maritimecrewingofvancouver.com



TODAYS DATE                                            DATE AVAILABLE
                              SPECIFY YOUR EMPLOYMENT PREFERENCES
                                 IN CANADA OR BC ONLY                         IN CANADA
INTERNATIONAL
                                 INCLUDING SHORE BASED                        OR USA ONLY
POSITION APPLIED                                YEARS OF EXPERIENCE AS APPLIED
SECOND POSITION                                 OR YEARS OF RELEVANT SKILLS
CITIZENSHIP                                     MINIMUM SALARY. NEGOTIABLE?
PERSONAL DATA
 FIRST NAME                              PASSPORT Nr                                     D.O.B.
FAMILY NAME                            PASSPORT EXPIRY                      PLACE OF BIRTH

Visa Details(US-C1D/B1/B2 )                     TYPE

Other VISAS                                     EXPIRY DATE
LANGUAGES SPOKEN FLUENTLY                       OTHER LANGUAGES
CERTIFICATION
MARINE LICENSE,                                 ENDORSEMENT,
TYPE                                            LIMITATIONS
COUNTRY OF
                                                ENDORSEMENT EXPIRY
ISSUE
OTHER MARINE                                    ENDORSEMENT,
LICENSE, TYPE                                   LIMITATIONS
COUNTRY OF
                                                ENDORSEMENT EXPIRY
ISSUE
      NAME OF INSTITUTION                DEPARTMENT / GRADUATED AS                        GRADUATION DATE


*only if no marine license
       *OTHER OR RELEVANT CERTIFICATION, TYPE
CONTACTS
PRIMARY CONTACT - MOBILE PHONE
HOME PHONE
E-MAIL ADDRESS
NEAREST AIRPORT
HOME ADDRESS
NEXT OF KIN FULL NAME                                     RELATION
CONTACTS and ADDRESS

YOUR EXPERIENCE INCLUDING SHIPBOARD, SHORE-BASED OR MARINE RELATED
  VESSEL NAME                  VESSEL       ENGINE
                  POSITION                                 OWNERS                                     DATES
      FLAG                    TYPE. DWT   TYPE. BHP




CURRENT / AVAILABLE REFERENCES.
NAMES, CONTACTS
OTHER - IF NO PREVIOUS SHIPBOARD
EXPERIENCE OR SEEKING SHORE BASED
EMPLOYMENT. SPECIFY RELEVANT SKILLS




                                            Page 1 of 2
                                                                    GENERAL APPLICATION FORM
                                                              See Terms and Conditions for Seafarers before applying.
                                                              Information you provide with this application is absolutely
                                                              confidential and will be only disclosed to the potential
               Professionals anytime, anywhere .              employer upon your agreement.
www.maritimecrewingofvancouver.com                               e-mail: info@maritimecrewingofvancouver.com


                SELECT TYPE OF VESSEL AND LOCATION PREFERRED answer yes or no

                                                             ANY OTHER TYPES OF VESSELS,
PASSENGER VESSELS – INTERNATIONAL
                                                             INTERNATIONAL
ANY VESSEL TYPE IN
                                                             ANY OTHER VESSEL TYPES IN
                         BRITISH COLUMBIA
                                                                                 CANADA ONLY
    ONLY
   Answering ‘Yes’ to the following questions I confirm that I possess STCW-95 compliant certificates
                     valid for at least plus two years from the date of application.
BASIC SAFETY COURSE                                          BASIC SAFETY COURSE
SURVIVAL CRAFT                                               SURVIVAL CRAFT
ADVANCED FIRE FIGHTING                                       ADVANCED FIRE FIGHTING
MEDICAL FIRST AID                                            MEDICAL FIRST AID
GMDSS, GOC or ROC mark one                                   GMDSS, GOC or ROC mark one
ARPA                                                         ARPA
BRIDGE RESOURCE MANAGEMENT                                   BRIDGE RESOURCE MANAGEMENT
FAST RESCUE BOAT                                             FAST RESCUE BOAT
 ISM CODE COURSE                                             ISM CODE
SECURITY OFFICER, ISPC                                       SECURITY OFFICER, ISPC
HAZARDOUS MATERIAL TRAINING                                  HAZARDOUS MATERIAL TRAINING
CROWD CONTROL MANAGEMENT                                     MEDICAL CARE ON BOARD
US PUBLIC HEALTH                                             OIL TANKER FAMILIARIZATION
US C 1/D Visa, other visas, green card                       ADVANCED OIL TANKERS TRAINING
VALID SEAFARERS MEDICAL TEST                                 CHEMICAL TANKER FAMILIARIZATION
* CANADA AND USA ONLY, deck officers.                        ADVANCED CHEMICAL TANKER
VESSEL DELIVERIES OR SHORT ASSIGNMENTS. SPECIFY
GEOGRAPHIC AREAS YOU HAVE STRONG EXPERIENCE.                 CRUDE OIL WASHING
                                                             INERT GAS SYSTEM
                                                             VALID SEAFARERS MEDICAL TEST
     LIST ANY OTHER SKILLS
 OR GIVE US SOME ADDITIONAL                                  LIST ANY OTHER CERTIFICATES
INFORMATION RELATIVE TO THIS                                 OR GIVE US SOME ADDITIONAL
 APPLCATION SUCH AS SPECIFIC                                 INFORMATION RELATIVE TO THIS
      EXPERIENCE OR YOUR                                     APPLCATION SUCH AS SPECIFIC
  SPECIALTIES IF YOU HAVE NO                                 TRAINING NOT LISTED ABOVE
     SEAGOING EXPERIENCE
  LIST EXPIRING OR ADDITIONAL
        CERTIFICATES HERE                                    LIST EXPIRING CERTIFICATES HERE

1. I authorize MCV LTD. to share above information with a    Please write Your name below                           Date
   potential employer on my behalf.
2. I am agree with the Terms and Conditions for seafarers.


* Attach you pictures separately to this form, but within the same application.
Max. picture size 250 mb. If you have an updated Resume please also submit it.

Thank You for applying! E-mail this form to: info@maritimecrewingofvancouver.com

* Do not attach any certificates copies at this time.

OFFICE USE ONLY




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