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Officer's Application Form

  |  CAREER  |  Officer's Application Form

Scot application number

Method of Interview

A) Primary Information

Name & Surname

Application Date

Date And Place Of Birth

Nationality

Graduated School and Year

TC. Id No

Religion

Marital Status

Military Status

Competency

Requested job/rank

Willing to accept lower rank

When did you disembark from your last vessel

Date available to start work

Mobile Phone

Home Phone

E-Mail

B) Personnel Information

Passport No

Passport Expire Date

Seamans Book No

Seamans Book Exp. Date

Medical Exam. Expire Date

Certificate of vaccination expire date

Date of expire USA visa (if any)

Number of entries for USA visa

Date of expire Schengen visa (if any)

Number of entries for Schengen visa

Have you ever been refused by schengen countries when you applied to obtain visa?

Have you ever been refused by USA when you applied to obtain visa?

Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty or other similar legal action?

C) Contact Details

Next of Kin

Next of kin phone number

Next of second kin

Next of second kin phone number

Home Address

Dependants (e.g wife, sons and daughters)
Name Surname Relationship Date of Birth

D) Medical Condition

Blood group

Do you smoke? If yes, for how long?

Do you have a surgical background? If yes, please specify

Are you currently under any medical treatment

Are you under regular medication? If yes, please specify

Do you have any idiopathic or allergic diseases ?

E) Physical Information

Height

Weight

Feet No

Shirt & Pants No

F) Abilities

English

Turkish

Other foreign languages

Computer knowledge

G) Certificates & Training

Status of Compentency & Certificates (all must be valid minimum 6 months)
Proficiency in survival craft and rescue boats certificate
Personal safety and social responsibility training certificate
Elementary first aid training certificate
Personal survival techniques training certificate
Fire prevention and fire fighting training certificate
Radar observation and plotting training certificate
The operational use of automatic radar plotting aids (arpa) training certif.
Medical care training certificate
Medical first aid training certificate
Advanced fire fighting training certificate
Cert. of prof. in basic training for oil and chemical tanker cargo operations
Cert. of profciency in advanced training for oil tanker cargo operations
Cert. of profciency in advanced training for chemical tanker cargo operations
Ship security officer certificate
Security related familiarization certificate
Security awareness certificate
Designated security duties certificate
Bridge resources management certificate (ex BTM certificate)
Leadership and teamwork skill training seminar
Engine resources management certificate
High voltage (1000 volt) training
Safety officer training certificate
ECDIS Electronic chart display information system training cert. (generic)
ECDIS Type specific training certificate
GMDSS/GOC General Radio Operator Certificate
Navigational watch keeping certificate
Engine-room watch keeping certificate
Cargo and ballast handling tanker simulator training certificate
Ship handling training certificate
Hygiene training certificate
Certificate/Document of Compliance for Ship Cook
Proficiency in fast rescue boats certificate
Malta flag state competency endorsement
Please write name of courses & trainings you attended related with your occupational needs

H) References

Please write reason to leave from your previous company

First Reference Information

Name & Surname Company name Title Phone number

Reference comment (complete by scot crew departmen)

Training Needs (From the reference)

Reference result

Second Reference Information

Name & Surname Company name Title Phone number

Reference comment (complete by scot crew departmen)

Training Needs (From the reference)

Reference result

Third Reference Information

Name & Surname Company name Title Phone number

Reference comment (complete by scot crew departmen)

Training Needs (From the reference)

Reference result

Experience

Previous shore experiences (if any) (please start from the last one)
1 -
2 -
3 -
4 -
Sea Experiences (please start from the last one)
Company Ships name Type Tonaj (dwt) Rank Total month
Other Experiences
Vetting/SIRE Inspections
CDI Inspections
USCG Inspections
Drydock Experiences
Ice Navigation Experiences
Ship to ship Experiences
Engine and equipment experience (only for Engineers)







Tanks coating experience (only for Deck Officers)



Cargo pump experience




Fosfa products experience








Petroleum products experience (only for Deck Officers)

































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CONTACT INFO

Scottanker
Caddebostan Mah. Çam Fıstığı Sok No:2 Kadikoy 34728 Istanbul -Turkey
+90 216 301 17 17 info@scottanker.com
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