Template - LANPAN CV

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SEAFARER APPLICATION &

CURRICULUM VITAE (CV)

POSITION APPLIED FOR DATE

PERSONAL DETAILS
Nationality
Surname Middle Name Last Name

Age
Date of Birth Place of Birth Religion

Education Qualification COC Grade Marital Status Height/Weight

Passport Number Issuing Authority Date of Issue Date of Expiry Overall Size

Issuing Authority
Seaman’s Book Number Date of Issue Date of Expiry Safety Shoe Size

Mobile Phone Number House phone Number Email Address Hometown Airport

Permanent Address:

NEXT-OF-KIN
Contact Number
Name 1. Relationship
1
1.
2. 2
2.
Address (if different from the above)

Certificate Issuing
Officer Certification (STCW) Date of Issue Date of Expiry
Number Authority
Certificate of Competency
Endorsement Certification and
Watch keeping
Certificate of GMDSS Radio
Operator
GOC ORU Booklet
SEAFARER APPLICATION &
CURRICULUM VITAE (CV)

Certificate Issuing
Rating Certification (STCW) Date of Issue Date of Expiry
Number Authority
Certificate of Proficiency
Ship Cook Cert

Certificate Issuing
STCW CERTIFICATES Date of Issue Date of Expiry
Number Authority
Basic Safety Training
Proficiency Survival Craft & Rescue Boat
Advanced Fire Fighting
Medical Care On Board Ship
Medical First Aid
Ship Security Officer
RADAR
ARPA
BTM/BRM/ERM
ECDIS
Security Awareness Training
Seafarers With Designated Security Duties
IMDG CODE
Crisis Management and Human Behaviour
Crowd Management
ISM Code & Port State Control
Certificate of Region ( COR )
Seafarer Identity Document for Foreigners
Food Handling Certificate
Food Hygiene Certificate

Date of
Flag Documents Certificate Number Issuing Institute Date of Expiry
Issue

Date of
OFFSHORE CERTIFICATE Certificate Number Issuing Institute Date of Expiry
Issue
BOSEIT (OPITO Approved)
H2S
RIGGING & SLINGING
SEAFARER APPLICATION &
CURRICULUM VITAE (CV)

Certificate
Type of Offshore Medial Medical centre Date of Issue Date of Expiry
Number

Certificate
Vaccination (For Cook) Medical centre Date of Issue Date of Expiry
Number
Typhoid
Hep A
Hep B

Record of Sea Service

Name of Vessel Engine Trading Scope of


Company GT HP Rank Sign On Sign Off
Vessel Type Type Area Operations
SEAFARER APPLICATION &
CURRICULUM VITAE (CV)

I confirm that the information given by me herein is true and correct. I also understand that any falsification or
misrepresentation in my personnel records can result in my immediate dismissal and may be subject to legal action if
I am employed by the Company. I do agree to submit myself to a thorough medical examination, which I must
successfully pass as one of the conditions for being accepted for employment.

Date: Applicant’s Signature:

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