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APPLIED JOB POSITION
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 Position Applied For
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Second Choice
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PERSONAL DETAILS
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Surname
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Firstname(s)
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Address
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Address
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ZipCode and City
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Country
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Nationality
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Phone
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Please remember country code
in front of phone no.
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Mobile
Phone
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Please remember
country code in front of phone no.
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E-mail
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Date of
Birth
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Place of
Birth
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Nearest
Airport
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English
Proficiency
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Marital
Status
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PASSPORT / DOCUMENTS
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Number
Date of Issue Date of
Expiry Issuing Authority
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Passport
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Seaman's Book National
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Seaman's Book Internat.
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VISA
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Tanker Certification
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Oil
Gas
Chemical
General Tanker Certificate
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CERTIFICATE OF COMPETANCE
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Certificate of Competance
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Issuing Authority
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STCW
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COURSES / CERTIFICATES
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(All documents must be
STCW95 endorsed)
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Number
Date of Issue Date of
Expiry
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PREVIOUS SEA SERVICE
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Start Date
End Date
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Vessel
Name
Vessel
Type Flag
Engine
Rank
Company
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PERSONAL COMMENTS
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Personal Comments
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SEND
APPLICATION
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I hereby declare that the above, including Medical History, is true. I further consent to the collection, holding and processing by you and any of your direct or indirect parent or subsidiary or associated or affiliated companies ("IMC SHIP MANAGEMENT") of personal data about me (including where appropriate data concerning racial or ethnic origin, religious beliefs, membership of a trade union, physical or mental health or condition, commission or alleged commission of an offence and the proceedings and the outcome of any proceedings relating thereto) for all purposes related to my application for employment on board vessels managed by IMC SHIP MANAGEMENT, owned or operated by third parties for whom IMC SHIP MANAGEMENT is engaged to provide crew. I understand and agree that this data will be stored in your databases in relation to my actual or potential employment by or through IMC SHIP MANAGEMENT (the "purpose"). Further, I confirm and agree that IMC SHIP MANAGEMENT may transfer or disclose my personal data within IMC SHIP MANAGEMENT or to third parties worldwide for the purpose.
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Send Application To
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