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    OFF MHR 001a Application For Employment

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    joseans20143
    This document is an application for employment with GasLog LNG Services Ltd. It requests personal information such as name, contact details, education/certification details, sea service history, and availability from applicants. Applicants must agree to GasLog's values of diversity, respect, cooperation and compliance. The final sections provide information on GasLog's privacy policy and how the applicant learned about the company.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    OFF MHR 001a Application For Employment

    Uploaded by

    joseans20143
    7 views2 pages
    This document is an application for employment with GasLog LNG Services Ltd. It requests personal information such as name, contact details, education/certification details, sea service history, and availability from applicants. Applicants must agree to GasLog's values of diversity, respect, cooperation and compliance. The final sections provide information on GasLog's privacy policy and how the applicant learned about the company.

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    OFF MHR 001a Application for Employment

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    This document is an application for employment with GasLog LNG Services Ltd. It requests personal information such as name, contact details, education/certification details, sea service history, and availability from applicants. Applicants must agree to GasLog's values of diversity, respect, cooperation and compliance. The final sections provide information on GasLog's privacy policy and how the applicant learned about the company.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    7 views2 pages

    OFF MHR 001a Application For Employment

    Uploaded by

    joseans20143
    This document is an application for employment with GasLog LNG Services Ltd. It requests personal information such as name, contact details, education/certification details, sea service history, and availability from applicants. Applicants must agree to GasLog's values of diversity, respect, cooperation and compliance. The final sections provide information on GasLog's privacy policy and how the applicant learned about the company.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    GASLOG LNG SERVICES LTD. EFFECTIVE DATE: 01 December 2020 - Revision No.

    : 00
    FORM OFF-MHR-001A PAGE 1 OF 2

    APPLICATION FOR EMPLOYMENT PHOTO

    DATE: …………………

    Rank Applied For : Date Of Availability:

    PERSONAL DESCRIPTION AND INFORMATION


    Full Name:
    Birth Date: Nationality:
    Marital Status: No. of Children:
    TRN/AΦΜ: TAX ID/ΔΟΥ:
    Military obligations (if applicable):
    Have you ever been arrested or convicted for a crime Yes / No
    GasLog values diversity and respects persons of different cultural backgrounds. GasLog also values respect, cooperation and
    compliance amongst our seafarers.
    Do you agree with this statement? Yes / No
    Permanent Address & Contact Details:
    Street: City / ZipCode: Country:
    Telephone: Mobile: Email:
    Next of Kin:
    Full Name: Relation:
    Address: Telephone Number:
    TRAVEL DOCUMENTS
    National Identification Card No: Date of Issue: Date of Expiry:
    Seaman Book No: Date of Issue:
    Passport No: Date of Issue: Date of Expiry:
    USA Visa: Date of Issue: Date of Expiry:
    VACCINATION
    Yellow Fever: Date of Issue:
    CERTIFICATE OF COMPETENCY / EDUCATION
    License/Rank:
    Number: Date of Issue: Date of Expiry:
    Marine Academy:
    CERTIFICATES / QUALIFICATIONS (please tick certificate below as appropriate)
    Basic Training for Liquefied Gas Tankers (STCW V/1-2-1) Date of Expiry:
    Advanced Training for Liquefied Gas Tankers (STCW V/1-2-2) Date of Expiry:
    Basic Safety Training (STCW A-VI/1-1 to A-VI/1-4) Date of Expiry:
    Advance Safety Training (STCW A-VI/2-1, A-VI/3, A-VI/4-1) Date of Expiry:
    Proficiency in Fast Rescue Boats (STCW A-VI/2-2) Date of Expiry:
    Security awareness / SDSD / SSO (STCW A-VI/6) Date of Expiry:
    Medical Care (STCW A-VI/4-2) Date of Expiry:
    ECDIS Generic (STCW A-II/1) Date of Expiry:
    ECDIS Specific (STCW A-II/1, STCW A-II/2) Date of Expiry:
    BRM/BTM Date of Expiry:
    Ship Handling Date of Expiry:
    ERM Date of Expiry:
    Incident Investigation Date of Expiry:
    Risk Assessment Date of Expiry:
    English Certificate Date of Issue:
    Other Diplomas:
    CERTIFICATES AUTHENTICITY CHECK Yes / No Date:________
    GASLOG LNG SERVICES LTD. EFFECTIVE DATE: 01 December 2020 - Revision No.: 00
    FORM OFF-MHR-001A PAGE 2 OF 2

    SEA SERVICE
    (PLEASE START FROM THE LAST SERVICE)

    ENGINES SIGNED ON SIGNED OFF SIGN OFF


    SHIP TYPE NAME OWNER D.W.T. DURATION RANK
    TYPE DATE DATE REASON

    TOTAL SEA SERVICE - Months:


    ACTUAL SEA SERVICE IN RANK - Months:
    ACTUAL SEA SERVICE ON THIS TYPE OF TANKERS - Months:

    I certify that all information provided is true and accurate.

    For more information on how the company processes your personal data, Gaslog has a privacy notice for off-shore job
    applicants, in accordance with the General Data Protection Regulation, which is available in the company’s official website:
    https://www.gaslogltd.com/privacy-notice-for-offshore-job-applicants.html

    HOW DID YOU COME TO KNOW ABOUT US? (Please tick the appropriate medium)
    A. Marine Club notice-board B. Marine magazine / newspaper advertisement
    C. Recommended by friend(s) (Please specify)
    D. Others (Please specify)

    SIGNATURE OF APPLICANT

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