Title: Form Manual
Operational Procedures
Form
MSC CREWING SERVICES MSC House, 92-v Lustdorfskaya road, Odessa 65088, Ukraine Tel.: +38 (0482) 333 891 Fax.: +38 (048) 7055 200 / E-mail: info@msccs.com
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APPLICATION FORM (Personal Data)
Position applied for __________________ License hold ___________________ Date Available __________
Family Name: Date of birth: Address:
Name: Place of birth:
Next of kin and relationship: Next of kin’s address: Inter. P’port No : Seaman's book No : Civil P’port No : USA visa No : TOSE :
Father's name: Nationality: Marital status: Nearest Airport: Home phone: E-mail: Mobile phone: Children (name & DOB): Next of kin tel: Valid: Place of issue: Valid: Place of issue: Place of issue: Valid: Place of issue: MARLINS, %: Date of issue:
Date of issue: Date of issue: Date of issue: Date of issue: Date of issue:
SEA GOING EXPERIENCE FOR THE LAST 7 YEARS (MOST RECENT VESSEL LAST)
Name of vessel
Version 00/01 Feb 19
Year of built
Company Owner / Ship Manager
Flag
Type of vessel
Page 1 of 2
DWT / TEU
ME type / Model
BHP
Rank
From DD/MM/YYYY
Form CD-P03-1
To DD/MM/YYYY