SEAMAN'S APPLICATION FORM
PERSONEL INFORMATION    
Name : Date of Application : 7/22/2018
Surname : Competency / Rank :
Date of Birth : Seaman Registry No :
Place of Birth City / Country : Seaman Port / Country : /
TC Num.( Turkish Citizens) : Seaman Book No :
Educational Institution : Expire Date of Seaman Book :
Military Service : Postponed No :
Finished Date
  Expire Date of Passport :
Marital Status : SSK No (Turkish Citizens) :
Conviction ? : YES NO Date you can sign-on :
Email Adress : @      
Home Address :
Foreign Language (VeryGood / Good / Poor )          
Language 1
: Home Phone Number : - -
Language 2
: GSM 1 : - -
Language 3
: GSM 2 : - -
PHYSICAL / HEALTH INFORMATION
Height : Shoe Size : Health Condition :
Weight : Trouser Size : Expire Date of Medical Exam.Cert. :
Blood Type : Boilersuit Size : Any physical handicap? : YES No
            Specify your physical difficulty :
PREVIOUS EMPLOYED COMPANIES ( LAST 4 )
Please specify your job information from past to present..
I don't have experience      
Company Name : Rank : Date Of Leave :
Vessel Name : Wage : USD (all included) Reason Of Leave :
Vessel GRT / Kw : Duration : Month      
Company Name : Rank : Date Of Leave :
Vessel Name : Wage : USD (all included) Reason Of Leave :
Vessel GRT / Kw : Duration : Month      
Company Name : Rank : Date Of Leave :
Vessel Name : Wage : USD (all included) Reason Of Leave :
Vessel GRT / Kw : Duration : Month      
Company Name : Rank : Date Of Leave :
Vessel Name : Wage : USD (all included) Reason Of Leave :
Vessel GRT / Kw : Duration : Month      
Name of the Company / Vessel / Duration you stayed OnBoard at longest / /
References Details
Name Surname Company Rank Phone Number
- -
- -
- -
Do you have any Endorsements? (Flag / Cert Name / Expiry Date )
Flag (Country) Cert Name Expiry Date
/ /
/ /
Additional Comments (certificates,GOC,ISPS? required rank,wage, flag , voyage,area etc )
  Select Image ... (JPG 120PX * 120PX) The file size must be smaller than 100 Kb  
PLEASE READ BEFORE SIGN: I HEREBY CONFIRM THAT ALL ABOVE INFORMATION ARE TRUE AND IN CASE OF MY ABILITIES FOUND CONTRARY TO MY DECLARATIONS ABOVE THEN I ACCEPTED TO BE OFFSIGNED FROM VESSEL WITHOUT RECEIVING ANY PRIOR NOTICE AND WILL BEAR ALL CONSEQUENTIAL EXPENSES ARISEN THERE FROM.




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