The
completion of this application does not guarantee
employment no colletc calls accepted
|
Notice
to Applicant & Employees
Screening test for alcohol and illegal drug
use may be required before hiring and during
your employe here. We are proud to be a Drug-Free
workplace |
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| Today`s
Date
|
| |
| Position
Requested |
| Position
Request 1
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|
Position
Request 2 |
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| Position
Request 3 |
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| Last
Name |
|
First
Name |
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| Middle
Name / Initial |
|
Nationality |
|
| Passport
Number |
|
Passport
Expiry Date |
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| Alien
Card Name |
|
Social
Security Number |
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|
| Visas |
| C1/D |
Y
N |
C1/D
Expiry Date |
|
| B1-B2 |
Y
N |
B1/B2
Expiry Date |
|
| Seaman`s
Book Number |
|
Book
Expiry Date |
|
|
| Permanent
Address |
| Street
and Number |
|
| City |
|
Country |
|
| Phone
Number |
|
Other
Number |
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(Country
Code, City, Number) |
|
(Country
Code, City, Number) |
| Fax
Number |
|
Email |
|
| |
(Country
Code, City, Number) |
|
|
| Date
of Birth |
|
Place
of Birth |
|
| Gender |
M
F |
Nearest
Home Airport |
|
|
| Personal
Info |
| Color
of Hair |
|
Color
of Eye |
|
| Height |
|
Weight |
|
| Religion |
|
|
|
| Emergency
Contact |
| Name |
|
Relationship |
|
| Street |
|
| City |
|
Country |
|
| Phone
Number |
|
|
|
| |
(Country
Code, City, Number) |
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| Languages |
Speak |
Read |
Write |
| English |
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| Spanish |
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| French |
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| German |
|
|
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| Italian |
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|
|
| Other |
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|
|
|
|
| Education |
| Education
Level |
|
Degree
Obtained |
|
| Date
of Degree |
|
|
|
|
| List
the Names of ships you have worked on before,
starting with the most recent |
|
| Certificates |
Yes
/ No |
| Basic
Safety Training |
Yes
No
|
| Crowd
Management |
Yes
No
|
| Others |
Yes
No
|
|
| Have
you ever worked on a vessel managed by Matchship? |
Yes
No
|
| If
yes, name of all ships |
|
| Do
you have relatives working for Matchship |
Yes
No
|
| Name |
|
Position |
|
| Name
of the ship |
|
|
|
| Have
you ever been injured |
|
| If
yes describe injury |
|
| Next
of Kin Name |
|
Next
of Kin Relationship |
|
| Next
of Kin Street |
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| Next
of Kin City |
|
Next
of Kin Country |
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| Next
of Kin Phone Number |
|
|
|
| |
(Country
Code, City, Number) |
|
|
|
| Reference |
| Please
supply the name and contact details of two people
we may contact for a reference |
| |
|
|
|
| Reference
1 |
| Company |
|
Position |
|
| Date
From |
|
Date
To |
|
| Supervisor |
|
Phone
Number |
|
| |
|
|
(Country
Code, City, Number) |
| Address |
|
| |
(Country
Code, City, Number) |
|
|
| |
|
|
|
| Reference
2 |
| Company |
|
Position |
|
| Date
From |
|
Date
To |
|
| Supervisor |
|
Phone
Number |
|
| |
|
|
(Country
Code, City, Number) |
| Address |
|
| |
(Country
Code, City, Number) |
|
|
| |
|
|
|
|
| If
you have an updated Resume/CV., and a photo,
please submit it by email to
info@matchship.com |
|
|
LINK: The International Maritime Organization
