BIG OCEAN SEAPAL

Application Form for Employment

List of positions I’m applying for:

1. Personal Data
Surname: Name: Father's Name: Permanent address:

Nationality: Date of birth: Place of birth: Phone: -

Mobile Phone:
Fax: -
E Mail :
Next of Kin: Name: Phone: Mobile: -

Document No. Issued Place Expiring Date

Passport
Seaman’s book
U.S.A. C1/D VISAS
Other VISAS
Other

2. Certificates/Courses
Highest Competency certificate held:
held:
Kind of Studies Specialization Mark / Grade Date of issue Place
Compulsory School
High School
University
Specialization Courses

A. STCW Courses & Other if in your hand (1 through 5)

Courses Conducted by Number Date/Place issued Expiring Date

(inst. / Ship)
1 Personal survival techniques (A-
VI/1)
2 Elementary first aid (A- VI-1)

3 Fire Prevention & Fire Fighting

(A- VI-1)

4 Personal Safety and Social

Responsibility (A- VI-1)

5 Maritime English
6 Familiarization with security and
safety practices

7 Crowd management knowledge

3. Please describe yourself

1 Height (Cm)
2 Weight (Kilo)
3 Skin’s Color
4 Hairs’ Color
5 Eyes’ Color
 BIG OCEAN SEAPAL
6 Marital Status
7 Children (How many & age)

4. Did you have any Sea Experience in the last years? (Most recent experience on top line)
Main Date
Company Vessel Flag Type DWT HP Rank Date to
Engine from

5. General Info

(A) Have you ever been denied a foreign visa? YES NO

If yes, state which country and reason.
Comment:

(B) Have you been the subject of a court of inquiry? YES NO

Have you been involved in a marine accident? YES NO
Comment:

(C) Have you ever used drugs? YES NO

If Yes, we would appreciate your comment:
Comment:

(D) Have you ever had problems because of Alcohol? YES NO

If Yes, we would appreciate your comment:
Comment:

(E) Hobbies:
List:
List: SPORTS, PAINTING, LISTENING TO MUSIC, TRAVELLING, GOING OUT

(F) Military Services?

Services? YES NO
Comment:

(G) Religion

(H) Nearest airport

(I) Please list your job experiences, starting from the last one and then explain why would you like to join a Cruise Ship?
Please attach relevant certificates.
 BIG OCEAN SEAPAL
(J) Knowledge of language * English please specify
F = Fair G = Good VG = Very Good E = Excellent M = Mother Language

Spoken Written Understand

*English
Spanish
French
German
Italian
Other

Above information I have rendered bound to achieve an employment with your Company. Above declaration corresponds
to the true and can be proven checking my seaman book or my discharges which I may produce any time upon request of
employing office, Master and or Shipping Company I will be eventually employed. Should any discrepancy arise on the
above given details, I will be fully responsible of the consequences which might arise, including but not limited, to the full
charge of cost I have caused for my employment and immediate repatriation from the ship.

DATE : SIGNATURE:

Photos

1.Passport
1.Passport photo 2.Full Figure photo

Please reply to:

BIG OCEAN SEAPAL S.R.L. GALATI Ariesului Street No. 19

N.I. J17/1684/2004 Tel: +40.745.19.07.46
+40.745.19.07.46;;
+40.743.67.05.67
+40.743.67.05.67
ROMANIAN NAVAL AUTHORITY +40.336.10.21.02
+40.336.10.21.02
Authorization APN 05 Nr. 0104 800112, Galati, ROMANIA
E-mail:crewrecruitment@yahoo.com
Web: www.bigocean
www.bigocean.ro
BIG OCEAN SEAPAL