APPLICATION FORM Page 1/2

BCM - Kotor, Stari Grad 436, 85350 Kotor, Montenegro

Tel: +382 32 30 46 96, +382 32 30 46 97, Fax: +382 32 32 54 43
info@bcm-kotorportagent.com, www.bcm-kotorportagent.com

Position: In Yachting since: Today's Date: Start Date:

Name: Salary: Negotiable Y N
Current Local Contact Address - Street/ Crew House:
City: State: Zip: Country:
Phone: Mobil\Voice: E-mail:
Permanent Address for future long term Contact (Parents or closest Relative)
Street: City: Country:
Permanent\Emergency Phone: Mobil\Voice:
Personal Data
Citizenship:
Other Citizenship (if applicable)
Drivers License# Country:
Social Security No.
Passport No. Expiry Date:
Visa Types: Expiry Date: Your
Height: Weight: M F Photograph
Hair: Eyes: Date of Birth: Goes Here
Clothing Size (US): Shirts: Pants: Shoes:
Do you smoke? y N Occasionally Daily
Do you drink? y N Occasionally Daily
Health status:
Special dietary
requirements:
Do you have tattoos that would be visible in a crew uniform? Y N I certify that information supplied by me in my resume,
Explain: via my verbal, manual or electronic input are correct to
the best of knowledge.
Languages spoken fluently:
Signature
Languages Communicated:
Computer Literacy: Beginner Intermediate Advanced
Drug test: Date taken: Will take: Y N
Ever convicted/ arrested: Y N Reason:
Agree to security check: Y N

Hobbies:

Additional skills
Dive Certified Y N Level:
STCW-95 Certified: Y N Date Completed:
 BOSUN / DECK HAND APPLICATION Page 2/2

BCM - Kotor, Stari Grad 430, 85330 Kotor, Montenegro

Tel: +382 22 30 46 96, +382 22 30 46 97, Fax: +382 22 33 44 77
info@bcm-kotorportagent.com, www.bcm-kotorportagent.com

Name
Date

Please list you Maritime license(s)

Expiration date Sea miles logged

Please rate your watch standing skill from 1to 5 (1=novice 5=expert)
Are you familiar with Yachting etiquette? Yes No
Can you perform you duties if seasick? Explain:
Will you assist in the engine room? Yes No
Please rate your engineering knowledge from 1 to 5 (1=novice 5=expert)

Please rate your experience on the following from 1 to 5 1=novice 5=expert

Wash down Corrosion repair Stainless
Polishing Carpentry Rust prevention
Painting Waxing Window treatments
Fiberglass Patching Bright work
Organization Inventory Purchasing
Stowage for sea

Please rate your toys & small craft handling experience on the following from 1 to 5 1=novice 5=expert
Tender less 16' Tender over'16' Kayaks
Jet skies Wave runners Scuba diving
Life rafts Scuba equipment Dive compressors
Windsurfing Water Skis Fishing

Please rate your rope work experience on the following from 1 to 5 1=novice 5=expert
Line handling Knots Splicing
Sewing and canvas work

Please rate your equipment knowledge on the following from I to 5 1=novice 5=expert
Radar Chart Plotting GPS
Weather fax VHF Satcom
Alarm systems Sextant

Please rate your safety knowledge on the following from 1 to 5 1=novice 5=expert
Fire safety Man overboard
SOS procedure Lifeboats

Please briefly answer the following questions:

Are you willing to assist the interior crew ?
Do you mind helping with children or pets?
Are you willing to share a cabin with the opposite sex?
How much time have you spent with shipyard and refit projects? Explain.

Do you intend to make a career in yachting? Please explain.

Would you sign and complete a one-year contract? Yes No Not Sure