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British Marine Careers Application Form



Please fill in all the required information.

Personal Particulars
Name:
Rank: Date Available:
Date of Birth: Nationality:
Address:

Telephone No.
Marital Status: No. of Children:
Name & Address of Next of Kin:

Relationship to you:
Passport No. Issued at:
Expiry Date:
U.S. Visa Type: Issued at:
Expiry Date:
Indian CDC Book: Issued at:
Expiry Date:
Vaccination Book: Yellow Fever Issue Date:
Expiry Date:

Watch-Keeping Certificate (Deck & Engine Ratings)
Rank:
 Certificate No.
 Issue Date:
 Expiry Date:
Education / Institution:
Training / Apprenticeship:

Details of Certificate of Competency
Cert. of Competency Rank Cert. No. Issued At Issue Date Expiry Date
National:
Other:

Sea Service Record
Company Vessel Type Rank From To
DWT/GRT Engine Type & Series BHP Y/N

Total Sea Service Record
Rank OSV
M / D		 Gencargo
M / D		 Bulker
M / D		 Other
M / D
MASTER / C/E / C/O / 2/E
2/0 or 3/E or E/O
3/0 or 4/E
Total

Record of STCW Certificates Held
Name of Cert. Cert. No. Issued At Issue Date Expiry Date
Personal Survival Technique / Craft- RB
PSSR
EFA / MFA / Masters Medicare
FPFF / Advance fire fighting
Radar Observer
ARPA
RANSCO (Radar Operator)
GMDSS
SSO
Others

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