Join the ASP Ship Management team......

ASP CM Seamen Employment Application Form

* Required field

Rank applied for:

Contact Details
First Name: *
Middle Name:
Last Name: *
Permanent Address: *
Local Address: *
Region: *
Telephone: *
Email:
Mobile:

Personal Information

Date of Birth:
Place of Birth:
Nationality:
Height:
Weight:
Blood Group:
Overall Size:
Safety Shoe Size:
Yellow Fever Iss. Date:
Home Town Airport:
Religion:

Next of Kin

Relationship:
Address:

Document Information

Document Number Place of Issue Date of Issue Expiry
Passport:
Seaman's Book:
US VISA - C1/D:
INDOS NO.

Family Details

  Name D.O.B P.O.B Passport No. Date of Issue Place Expiry Nationality
Wife:
Children:
:
:
:
:
:

Academic Background

Institution City + Country From To Qualification Grade
Pre-Sea Training Institute: From: To:
Apprenticeship / Jr. Eng.: From: To:

Certificate of Competency

  Grade Number Date of Issue Issuing Expiry Remarks
National C.O.C.:
GMDSS:
DCE - PET.:
DEC - CHEM.:
DCE - LPG:

Equivalent Endorsements

Place Grade Type Number Date of Issue Expiry STCW'95 Validity
Cyprus:
License:
Seamens Identity Documents:
GMDSS:
Marshall Islands:
License:
Seamens Identity Documents:
GMDSS:
Liberia:
License:
Seamens Identity Documents:
GMDSS:
Panama:
License:
Seamens Identity Documents:
GMDSS:
Singapore:
License:
Seamens Identity Documents:
GMDSS:
License:
Seamens Identity Documents:
GMDSS:
License:
Seamens Identity Documents:
GMDSS:
License:
Seamens Identity Documents:
GMDSS:

Minimum STCW Certificates

  Number Date of Issue Issuing Country Date of Expiry Name of Institute
Fire Fighting (FPFF):
Fire Fighting (ADV):
Personal Survival Tech.:
PSC & RB:
PSSR:
Ship Captain's Medicare:
Medical First Aid:
Elementry First Aid:

Other STCW Certificates

  Number Date of Issue Issuing Country Date of Expiry Name of Institute
Radar Observer:
ARPA:
Radar Simulator:
RANSCO:
Sp. Tanker Safety Pet.:
Sp. Tanker Safety Chem.:
Sp. Tanker Safety LPG:
OTFC:
CTFC:
GTFC:

Other Courses

  Number Date of Issue Issuing Country Date of Expiry Name of Institute
Manov:
Engine:
LCHS:
HAZMAT:
BTM:
BRM:
FRAMO:
TKR:
Bulk:
VRM:

Practical Experience

Have you experience of the following
New Building
Steam Turbines Cargo Pumps
Engine Driven Cargo Pumps
Cargo Pump type
a) Centrifugal pumps
b) Screw pumps
c) FRAMO pump
Cargo Pump type
Deck crane type
a) Thyrister control
b) Electrical
c) Electro hydraulic
d) Gantry
Planned Maintenance System
(a) Computerised (Specify)
(b) Others
Container (specify TEU)
Reefer container
Reefer Cargo
Dry dock
Major repairs
Major Fire
Collision
Pollution Incident
Enumerate the different Nationalities you have sailed:
Officers:
Ratings:
Reason for application:
Preference for employment on:
May we approach your PRESENT employer for Reference?:
Present Employer Name:
Present Employer Phone:
May we approach your PAST employer for Reference?:
Past Employer Name:
Past Employer Phone:
Have you ever had to leave a company other than voluntarily?:
What date are you available for sea service?:

Sea Service (for last 10 years)

Company Vessel Rank Type Flag DWT / GRT From To BHP Engine Type UMS (Y/N) TEU Capacity Reason for Signoff