Application form

Download the application form, fill it in and send it by e-mail: ums@crewservice.com.ua
or fax: +38 048-786-90-56

	Download application form:
	MS Excel, zipped
	PDF file*
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You can fill in and send the form right here

Surname		Name		Middle name
Date of Birth / Place of Birth			Nationality
Permanent address / Phones / Email
Marital status	Nbr of Children	Did you have any longlasting illnesses?			Shoes size
Next of kin Name (Relationship) / Address / Phones / Email					Age:
					ISM knowledge
Position applied for: Choose position Master Chief Officer Second Officer Third Officer Fourth Officer Deck Cadet Chief Engineer Second Engineer Third Engineer Fourth Engineer Engine Room Cadet Electrician Assistant Electrician Boatswain Able Seaman Motorman Cook Steward		Valid US Visa (if available)		Knowledge of English Choose: Bad Poor Sat OK Good V. Good Exl
Details of previous Employer (including Email or phones)
		Number	Issue date	Expiry date	Place of Issue
Foreign Passport
Seaman's book
License
Endorsement
GMDSS
Endorsement
Personal Survival Techniques (A-VI/1)
Proficiency in survival craft(A-VI/2)
Advanced fire flighting (A-VI/3)
Medical First Aid (A-VI/4)
Dangerous and Hazardous Cargoes    (B-V/4 & B-V/5)
Automatic Radar Plotting Aids (ARPAs)
Radar observation & plotting
Electrical, electronic & control engineering
International vaccinations (yellow fever)
National Medical Certificate
ISPS Certificate
SEA SERVICE (LAST 5 YEARS, LAST VESSEL FIRST)
RANK	FROM / TO	Name of Vessel / Owner	VSL TYPE / DWT	ME TYPE / BPH/ kWt	FLAG

Carefully check all your information in the form, then press "Send form".