Employment Application Form

sea chefs Cruises Ltd

sea chefs River Cruises Ltd
sea chefs River Management Ltd
PHOTO
Interview No: Crew I.D.:

Position applied for: Cabin Steward Department: Date: 2.09.2019

Surname: Tesic First Names: Branislav

Age 35
Address
Jovan Ducic 10,Lopare,Bosnia Sex: Male
Name Building/Block Mobile Telephone No: +38765 776 299
City/Town Lopare Home Telephone No: +38755 410 619
Zip/Post Code 75240
Country Bosnia
E-mail address: sneza.tesic.bane@gmail.com
Date and Place of Birth: 14.01.1984 Tuzla Bosnia Nationality: Bosnia(Serb)
Passport No: B0279232 Issue date: 02.06.2015Issue place: Lopare Expiry date: 2.06.2025
Seaman’s Book No: Issue date: Issue place: Expiry date:
Marital status: Single Relationship: Father
PERSONAL

Address: Jovan Ducic 10,Lopare,Bosnia

Next of Kin: Dragan Tesic Telephone No: +38765 776 739
Present Employment: company for orginazing celebrations Since when: 2018
Ever applied to this
Company before? No When?
Main departure
Recruitment Agency: Safe Cruise airport: Belgrade
Have you ever had any difficulties with the authorities, in any Jurisdiction or Country (i.e. Police, Customs,
Immigration etc.)? And if so, for what reasons?

This information is required to provide safety and security onboard our vessels and compliance with relevant
Authorities’ requirements. Once the information provided is verified it will be destroyed and no record will be
held.

I consent to the provision and verification of my criminal record Yes

I DO NOT consent to the provision and verification of my criminal record

EMPLOYMENT

Position: Name and Address of Employment: From – To (Dates): Reason for Leaving:
HISTORY

Assist in kitchen Scenic AG,Zug Swiss 08/2018 10/2018 nothing specific

Housekeeper Princess Cruise Lines,Los Angelses USA 11/2015 02/218 better salary
Room Attedant four-star hotel"Comsar"Ugljevik,Bosnia 04/2013 03/2014 better chance for improvment
Room Attedant Hotel"Majevica"Lopare,Bosnia 04/2011 04/2013 mainly better salary

Spoken Written Reading

Fair Well Excellent Fair Well Excellent Fair Well Excellent
ENGLISH x x x
LANGUAGES

GERMAN x x x
FRENCH
ITALIAN
SPANISH x x x
RUSSIAN x x x
OTHER:

F7.3 Employment Application Form Issue: 4 / Issue date: 24-05-2018 1/3

 Employment Application Form

sea chefs Cruises Ltd

sea chefs River Cruises Ltd
sea chefs River Management Ltd
EDUCATION

Education Name and Place of School Years Attended Year Graduated

High School Hight Mechanical school"Vuk Karadzic" Lopare 3 years 2001
College
Trade, Business
or Other School

SCHENGEN
Issue date:
MULTI / SINGLE USA
Issue place: Expiry date:
VISA

USA (C1/D1) Issue date: Issue place: Expiry date:

TYPE D PERMIT Issue date: Issue place: Expiry date:

Duration of
Certificate for Sea-Going Only No. Date of Issue Expiry Date
Training
CERTIFICATES

Basic Safety Training

DIPLOMAS /

Section (A-VI/1.2)
Section A-V/2 (par. 1,2,3,4,5) (state which paragraphs)
Section A-V/3 (par. 1,2,3,4,5) (state which paragraphs)
Crowd Management
Crisis Management

Are you currently under a doctor’s care with medication? YES NO

If yes please specify:

Do you have any recurring medical problems? YES NO x

If yes please specify:
MEDICAL

Are you on any medication? YES NO x

If yes please specify:
Do you have any physical and/or mental condition that would limit your ability to perform the job you are
seeking? No
Height : 173 cm Weight: 80kg
State if any defect in: No
Hearing:
Vision:
Speech:

We require your medical information for our legal obligation to conform with relevant laws, regulations and
international conventions which makes it obligatory for the company to hold and process such information.
(International Maritime Organization (IMO), International Labor Organization (ILO), Maritime Labor Convention (MLC),
The International Convention on Standards of Training, Certification and Watchkeeping for Seafarers (STCW). This
obligation is based on the obligatory medical examinations for issuance of the Fit-for-Duty Certificates. If your
employment application is not successful, your medical data will be immediately deleted.

I consent to the provision and process of my medical data YES

I DO NOT consent to the provision and process of my medical data

I have read and understood the company’s Privacy Policy on

Collection, Processing and Protection of Personal Data YES

F7.3 Employment Application Form Issue: 4 / Issue date: 24-05-2018 2/3

 Employment Application Form

sea chefs Cruises Ltd

sea chefs River Cruises Ltd
sea chefs River Management Ltd

I confirm that the above is to the best of my knowledge and belief correct.
I also understand that any false statement above is reason form dismissal if engaged.

Date: 02.09.2019 Signature of applicant: Branislav Tesic

Please attach a copy of the following documents:

No Documents 1 Sea-Going 2 River √ Expiry (Comments)

1. Passport (photo, name, expiry and visa pages)1, 2
2. Seaman’s Book 1
3. Vaccination Book 1
4. Qualification Certificates 1, 2
5. Training Certificates 1

To be completed by the interviewer:

Suggested
Name of interviewer: Date:
Positions
Languages: ENG: GER: FR: ITA: SPN: RUS: OTH:
INTERNAL USE ONLY

Evaluation
Criteria: Comments: 1
Appearance: 2
Experience: 3
Knowledge: 4
Suggested Vessels
Overall 1 2 3 4 5 1
Evaluation: Poor Fair Good Very Good Excellent 2
Interview Passed – Passed – Passed –
outcome: Contract offered Stand by Contract offered No offer
Failed 3

Signature of Interviewer :

F7.3 Employment Application Form Issue: 4 / Issue date: 24-05-2018 3/3