Lerus Crew Management// Recruiting services in Oil and Gas ...
Position applied for:
|Family Name: |Name: |Father's name: |
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|Date of birth: |Place of birth: |Marital status: |E-mail: |
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|Address: |Tel (including city code): |Mobile: |
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| | | |
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|Next of kin and relationship: |Children (name & DOB): |
|Next of kin’s address: |Next of kin tel: |
|Inter. P’port No: |Issued: |Valid: |Place of issue: |
|Seaman's book No: |Issued: |Valid: |Place of issue: |
SEA GOING EXPERIENCE FOR THE LAST 5 YEARS
( MOST RECENT VESSEL LAST )
|Name of vessel |Type of vessel |DP system/ |Flag |Company Owner |
| | |Type of DP system | | |
|Drug & alcohol test |Issued: |Valid: |Eyes: |Hair: |
|Yellow fever |Issued: |Valid: |Overall size: |Safety shoes: |
VISAS:
|Visa |Type |Issue |Expire |Visa |Type |Issue |Expire |
|Schengen visa | | | |UK visa | | | |
|USA visa | | | |Nigeria visa | | | |
FLAG STATE DOCUMENTS:
|UK CEC | |CYPRUS | |ITALIA | |NORWAY | |
|PANAMA | |A&B | |MADEIRA | |SINGAPORE | |
Pevious employers for references
|Company name | |Company name | |
|Contact person | |Contact person | |
|Email | |Email | |
|Phone number | |Phone number | |
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