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JOB APPLICATION FORM

For Deck Department

Please complete this accurately, giving as many details as possible of your skills and experience relating to this job application.

|Personal Information |

|Name: | |

|Birthday: | |Nationality: | |

|Telephone Numbers: Please include Country and Area Codes |

|Home | |

|Mobile | |

|Home | |

|Address: | |

| | |

|Email address: | |

|Identification Number: | |Expiry Date: | |

|(الرقم القومى) | | | |

|Passport Number: | |Expiry Date: | |

|( رقم جواز السفر) | | | |

|Seaman Book Number: | |Expiry Date: | |

|(رقم جواز السفر البحرى) | | | |

|Military service Status |

| ( Exemption (إعفاء) |

| ( Complete the service Military ( أتم الخدمة العسكرية) |

| ( Postponed (مؤجل) |

| ( Currently serving (حالياً فى الخدمة) |

| ( Does not apply (غير مطلوب للتجنيد) |

|Education |

|High School Diploma (شهادة الثانوية العامة أو ما يعادلها) |

|Date: | |Grade (%): | |

| B) Nautical Basic Studies( الدراسات الأساسية) |

|Date: | |Grade (GPA): | |

|Bachelor of Maritime Transport (Nautical Technology) |

|Date: | |Grade (GPA): | |

|Certificates of Competency |

|2nd Mate: | |

|1st Mate: | |

|Master: | |

|TRAINING & EXPERIENCE |

|Sea-Service Experience (Recent entry first and then backward)(الخبرة البحرية) |

|Vessel Name |

|Health (الحالة الصحية) |

|Is there anything concerning your medical history or state of health that is relevant to your |( Yes ( No |

|application? | |

|If yes, please explain |

|Language |

|Language |Fluency |

|English | ( Poor ( Fair ( Good ( Very good ( Fluent |

|Others ( , , ) | ( Poor ( Fair ( Good ( Very good ( Fluent |

|Training |

|Please list any training you have received or courses which did not lead to a qualification but which you feel is relevant to the Application.(مثل |

|دورات اللغات والكمبيوتر وما شبه ذلك) |

|Training Course |Date |

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| | |

| | |

| | |

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|Hobbies & Interests ( إهتمامات وأنشطة رياضية) |

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|Short Courses (الشهادات الحتمية) |Date of issue |

| |Elementary First Aid A-VI/1-3 | |

| |Personal Survival Techniques & Search and Rescue | |

| |Personal Safety and Social Responsibilities | |

| |Fire Prevention and Fire Fighting | |

| |Advanced Personal Survival Techniques | |

| |Proficiency in Personal Survival Techniques. | |

| |Medical First Aid | |

| |Medical Studies | |

| |Passenger Safety, Cargo Safety | |

| |Crowed Management, Familiarization | |

| |Proficiency in Survival Crafts | |

| |Advanced Fire Fighting | |

| |Proficiency in fast Rescue Boats | |

| |Advanced Communication | |

| |International Code for the Security of Ships, and Port Facilities | |

| |Ship Security Officer | |

| |Company Security Officer | |

| |Port Security Officer | |

| |Proficiency as a Ship Security | |

| |STCW convention Familiarization | |

| |Port State Control Course for Seafarers | |

| |Basic Knowledge of GMDSS | |

| |Shipboard Safety Officer | |

| |Implementation of International Maritime Dangerous Goods (IMDG) Code on board Ships | |

| |Oil Tanker Familiarization | |

| |Liquefied Gas Tanker Familiarization | |

| |Advanced Chemical Tanker Operations | |

| |Marine Radar and Automatic Radar Plotting Aids | |

| |Radar Simulator | |

| |General radio Officer Certificate (GOC) | |

|Other courses |

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| |Date : |

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Reg. No.

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