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F0606 Application For Employment

This 3-page document is an application for employment as a seaman. It requests personal details, qualifications, certificates, endorsements, experience, medical information, and English language ability. The applicant provides their name, date of birth, passport information, qualifications, seafaring experience across 12 ships, medical documents, and English language competency level. The bottom section is for comments and signatures from the company's HR department and manning agent regarding the applicant.

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Ihwan Asrul
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36 views3 pages

F0606 Application For Employment

This 3-page document is an application for employment as a seaman. It requests personal details, qualifications, certificates, endorsements, experience, medical information, and English language ability. The applicant provides their name, date of birth, passport information, qualifications, seafaring experience across 12 ships, medical documents, and English language competency level. The bottom section is for comments and signatures from the company's HR department and manning agent regarding the applicant.

Uploaded by

Ihwan Asrul
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 3

Form F06-06

Issue Date: 01.09.05


APPLICATION FOR EMPLOYMENT Issue No: 02
Rev. Date: ---
MAGNUS CARRIERS
(SEAMAN) Rev. No: 00
CORPRATION Page: 1/3

A. Personal data & Documents

Date of birth. Seaman Name.


Name of father. Seaman Middle Name.
Name of mother. Seaman Surname.
Name of wife. Rank.
Number of children. Nationality.
Address. Religion.
Seaman’s Book no.
Passport number. Place of issue.
Place / date of issue. Date of issue.
Passport exp. date. Last sign off date.

B. Qualifications & Diplomas according to STCW’95 conventional requirements.

Name of Certificate: Number: Issued on: Expires on: Authenticated on:

National certificate
of competence
National endorsement of
competence certificate*

GMDSS G.O.C. (IV/2)*

Personal Survival
Techniques (VI/1.1)
Fire Prevention & Fire-
fighting (IV/1.2)
Elementary First Aid
(IV/1.3)
Personal Safety & Social
Responsibility (IV/1.4)

Medical First Aid (VI/4)

Medical Care (VI/4)

Survival Craft & Rescue


Boats (VI/2.1)
Fast Rescue Boats
(VI/2.2)
Advanced Fire-fighting
(VI/3)
Tanker Familiarization
Course (V/1)
Shore-based fire-fighting
course (V/1)
Oil Tanker Specialized
Training (V/1)
Chemical Tanker
Specialized Training (V/1)

C. Flag State Endorsements of Recognition for certificates with (*)

Name of Certificate: Number: Issued on: Expires on: Authenticated on:


Form F06-06
Issue Date: 01.09.05
APPLICATION FOR EMPLOYMENT Issue No: 02
Rev. Date: ---
MAGNUS CARRIERS
(SEAMAN) Rev. No: 00
CORPRATION Page: 2/3

C. Flag State Endorsements of Recognition for certificates with (*) continues….

Name of Certificate: Number: Issued on: Expires on: Authenticated on:

D. Seaman’s book:

Nationality: Number: Issued on: Expires on: Authenticated on:

E. Additional Courses.

Documents: Number: Issued on: Expires on: Authenticated on:


1

10

F. Experience / Service Record.

Serviced from /
Ship’s Name Company DWT Ship Type Eng. Type Rank
to
1

F. Experience / Service Record (continuous…)


Form F06-06
Issue Date: 01.09.05
APPLICATION FOR EMPLOYMENT Issue No: 02
Rev. Date: ---
MAGNUS CARRIERS
(SEAMAN) Rev. No: 00
CORPRATION Page: 3/3

Serviced from /
Ship’s Name Company DWT Ship Type Eng. Type Rank
to
9

10

11

12

G. English language competency level (interview & exam test required).

Ability Understands Speaks Reads Writes Comments on language ability (mandatory)

Excellent
Good
Fair
Poor Score on English Language Test Exam: …………………

H. Medical.

Document: Number: Issued on: Expires on: Authenticated on:

Medical Card (I/9)


Vaccinations

Authenticity of Diplomas &


Licenses checked & verified.

CONFIDENTIAL
Manning Agent Signature.
F. Inquiry and/or Interview Results.

Company H/R Dept. Comments: Manning Agent Comments:

Human Resources Manager


Signature

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