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Attn.

: Marlow Navigation

SEAFARER'S APPLICATION FORM - Page 2 of 3 - LIST OF DOCUMENTS


Please note that due to legal requirements boarding is only possible after we are in possession of photo copies of all listed documents and certificates - in urgent cases you may therefore have to send them email (color scans in .jpg format - max. 600 pixels wide and max. 900 pixels high) or by fax or courier. Passport photos may arrive later (by mail). Family First Name Name(s) A. TRAVEL DOCUMENTS AND MEDICAL CERTIFICATES Document Name (Desciption) Document Number Country Passport Seaman's Book (national) Seaman's Book (flag state) Seaman's Book (flag state) Visa - United States (type C1/D) Visa - Others (Work/Resid. Permits) Medical Examination Report Drug & Alcohol Test Vaccination against Yellow Fever Vaccination against Cholera Passport Photos Rank

Issue Place Issue Date Exp. Date

please mail 6 for deck officers & 4 for other ranks (required for flag states)

B. CERTIFICATES OF COMPETENCY & ENDORSEMENTS, COURSE CERTIFICATES - deck & engine certificates & endor- - radio certificates & endorsements - nav., deck, technical & management sements (officers / ratings) - safety training (surv., fire, medical) courses (radar/ARPA, ISM, Marpol, - electrical & reefer certificates - tanker courses (oil, chem., gas) simulators, computer, welding etc.) - cook & steward certificates - passenger vsl, roro, hazmat courses - any flag state certificates Document Name (Description) Document Number Country Issue Place Issue Date Exp. Date

Date:

Signature:

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