Application for seagoing position

Name: *

I apply for a position as: *

Date of birth:

Address:

Zip code:

City:

Phone: *

Cell phone:

E-mail:

Details

Passport: (No, Issue date, Expiredate)

Seamans book: (No, Issue date, Expiredate)

Health certificate: (No, Issue date, Expiredate)

Main certificate: (No, Issue date, Expiredate)

Fire course: (No, Issue date, Expiredate)

Oil certificate: (No, Issue date, Expiredate)

Chemical certificate: (No, Issue date, Expiredate)

GOC certificate: (No, Issue date, Expiredate)

Healthcare course: (No, Issue date, Expiredate)

BRM/MRM Course: (No, Issue date, Expiredate)

ECDIS:

List flag state endorsements:

Wisby Tankers AB - Wisby Ship Management AB