PLEASE COMPLETE THE FOLLOWING:

 

 Position Applied: *       Alternate Position: *
 
 PERSONAL DETAILS
Last Name: * First Name: * Middle Name: *
Date of Birth: * Place of Birth: * Age: *
Present mailing address: * Landline number: *
E-mail address (if any): Cell phone number:
Sex: * Religion: *  
 
EDUCATIONAL ATTAINMENT    
Name of last school attended: *  
Degree/Certificate obtained: *  
Completion date: *  
 
SHIPBOARD EMPLOYMENT DOCUMENTS  
       
Passport Place issued: Number: Validity:
Seaman's book Place issued: Number: Validity:
Yellow Fever Place issued: Number: Validity:
US Visa Place issued: Number: Validity:
GOC Certificate Place issued: Number: Validity:
PRC endorsement Rank: Number: Validity:
TESDA COC Rank: Number: Validity:
       
       
TRAINING CERTIFICATES Date Issued Name of Training Center NAC COP Certificate no.
Basic Safety Course (BSC) 14-
Personal Safety and Social Responsibilities N/A
Proficiency In Survival Craft and Rescue Boat 15-
Medical Emergency-First Aid (MEFA) 18-
Specialized Training in Oil Tanker Operation 9-
Specialized in Chemical Tanker Operation 10-
Specialized Training in Liq. Gas Tanker 11-
General Tanker Familiarization (GTF) 8-
Shore-Based Fire Fighting (SBFF) N/A
Inert Gas System / Crude Oil Washing N/A
Engine / Deck / Navigational Watch Keeping N/A
Ship Simulator and Bridge Teamwork N/A
 

 SHIPBOARD EXPERIENCE

 

Latest Contract

Two contracts ago

Three contracts ago

Four contracts ago

Five contracts ago

Name of vessel

Flag

Year Built

GRT

Trade route

Main Engine

Type of Vessel

Rank

Salary (All in)

US$

US$

US$

US$

US$

Sign on (DD/MM/YY)

Sign off (DD/MM/YY)

Reason for signing off

Nationality of Master

Nationality of C/Eng

Name of Principal

Nationality of Principal

Name of Philippine Manning Agency

 

*Required Fields (do not leave blank)

 

 

 

 

 

 

 

 

3906 Woodland Park Centre, Hen. Macabulos St.,
Bangkal, Makati City, Philippines, 1233
E-mail address: agile@agilecrew.com
©2011 Agile Maritime Resources Inc. All rights reserved.