Seafarer'S Application Form - Scotland Crew Department
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Northern Marine Management
Alba House
2 Central Avenue
Clydebank
G81 2QR
Scotland, UK
Crew Department - Recruitment Group
Tel: +442032863705 - Email:
SEAFARER'S APPLICATION FORM - Page 1 of 3 - PERSONAL DATA
PERSONAL INFORMATION
Family Name
First Name (s)
Birth Date
Birth Place
Nationality
Religion
Marital Status
No. of Children
Height (cm)
Weight (kg)
Nearest Airport
Alternative Airport
ADDRESS (include telephone country & area codes, advise also secondary or contact addresses if any)
Street & Nr.
Email Address
Location
Mobile Phone
City
Residence Phone
State, Country
Fax
Postal (ZIP) Code
P.O. Box (if any)
NEXT OF KIN INFORMATION (person to contact in case of emergency & insurance beneficiary)
Family Name
First Name(s)
Nationality
Relationship
Street & Nr.
Email Address
Location
Mobile Phone
City
Residence Phone
State, Country
Fax
Postal (ZIP) Code
P.O. Box (if any)
REMARKS
Requested Rank
Availability Date
Prefer. Vessel Type
Minimum Salary
Spoken: fluent / good / average / poor - Written: fluent / good / average / poor
English Language Skills
Other Foreign Languages
Professional School / Academy
- Name & Period (From - To)
Foreign Crew Experience
(specify nationalities)
Other Skills
Further Remarks
Please advise how you heard
/
Newspaper / Advert
Google / Internet / Relative / Other Seafarer
School / University / Other sources ……………………..
about Marlow Navigation:
(underline appropriate option)
I hereby affirm that all the information provided by me in this application is true and correct to the best of my knowledge.
Date:
Signature:
Note: This form can be returned per email without signature - please ensure however to send a signed printout for our records afterwards per
mail (e.g. with the passport photos and photo copies required). Please sign all 3 pages of the application form separately.
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