OCEAN TANKERS

SEAFARER EMPLOYMENT APPLICATION FORM

Post Applied For: Date Available For Joining: (dd/mm/yy)

1. PERSONAL PARTICULARS
Full Name (as in passport):
Date of Birth: (dd/mm/yy)	Place of Birth:	Nationality:
Religion:	Marital Status:	Sex: Male Female

2. CONTACT
Address:
Tel No:	Handphone:	Email:

3. ACADEMIC QUALIFICATIONS
From	To	Instituation/Universities Attended	Qualification

4. CERTIFICATES (To provide all COC, STCW cert, passport & seaman book detail)
Certificate Type	Certificate No.	Issue Date	Expiry Date	Issued by
COC:
Authentication Letter Yes No
Passport:
Seaman Book/CDC
Dangerous Cargo Endorsement/Tanker Cert.

5. DETAILS OF SEA SERVICE (For last 5 years)
Company	Vessel Name	Vessel Type	GRT	Engine Type	BHP/KW	Rank	From	To	Period

6. MEDICAL HISTORY / BACKGROUND
a) Do you have any history of family or personal illness such as tuberculosis, high blood pressure, mental illness etc?	Yes No
b) Have you ever been hospitalised, operated or currently undergoing some kind of medical treatment?	Yes No
c) Do you have an emotional or physical handicap (disability)?	Yes No
d) Have you ever been charged in court for any offence?	Yes No
e) Have you ever applied to Ocean Tankers (Pte) Ltd or affiliated concerns of Ocean Tankers (Pte) Ltd?	Yes No

If answer is "Yes", please give details below

Please provide names and contact details of 2 persons (past employers) known to you for the last 3 years.

Declaration by Applicant

I certify that all statements given on this application are correct and true to my knowledge. I also understand that falsification or misrepresentation (intentionally or unintentionally ) in this or any other personnel records can result in my immediate dismissal and forfeiture of all wages, allowances and benefits 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.