NOTE: A copy of this completed form will be forwarded to your email address after submission.

Application for position as:

Title:
Surname:
  
Forenames:
  
Address:
  
Telephone:
  
Mobile:
  
email:
  
Local Airport:
  
Place of Birth:
  
Marital Status:
  
Nationality:
  
   

Next of Kin:

Name:
Relationship:
  
Address:
(if different from above)
  
Telephone:
  


Passport No.
National Insurance No.
Issued at:
Expires:
Discharge Book No.
 
US Visa:
 yes no
Type:
Place of Issue:
Expiry Date:
Issue Date:
 

Languages (please indicate level of proficiency: Fluent - Fair - Poor)
Language English Spanish German Portugese French
Written
Spoken
Others (Written)
Others (Spoken)

Education and Training
Educational Qualifications
Subject/Grade

Where did you hear about Maersk recruiting?

Press - Nautilus UK MER Magazine PR
Website - marine-recruitment.com imarest.org nautilusuk.org
Website - Other, please specify
Radio Word of mouth
Other - Please specify


Cadet/Apprentice
From
To
Company
Qualification Achieved

Professional Qualification/Certificate
No.
Date
Certificate revalidation (Every 5 years)
Dangerous Cargo Endorsements Petroleum
  Gas
  Chemical

Marine Courses Attended

 
Date
Elementary First Aid (1 Day)
Merchant Navy Basic Fire Fighting (3 day)
Merchant Navy Advanced Fire Fighting (4 day)
Merchant Navy Fire Team Leader/Command & Control
Basic Sea Survival
Elementary First Aid
Medical First Aid (4 day)
Proficiency in Medical Care Onboard Ship
Standby Vessel Advanced Medical Aid
Standby Vessel Command & Control
Standby Vessel - Initial Training for Shipboard operations
Helicopter Underwater Escape Training
Fast Rescue Craft (Boatman)
Fast Rescue Craft (Coxswain)
Draughtercraft Coxswain
Certificate of Proficiency in Survival Craft
G.M.D.S.S General Operations Certificate
Navigation, Radar & ARPA Sim Training (Operational Level)
Navigation, Radar & ARPA Sim Training (Management Level)
Electronic Chart Display & Information Systems
Dynamic Positioning (Basic)
Dynamic Positioning (Advanced)
Manned Model Shiphandling
Shiphandling Simulator Course
Bridge Team Management Course
Engine Team Management Course
Crew Resource Management Course
Crisis Management
Management of Major Emergencies
Offshore Emergency Helideck Team Member
Helideck Assistant
Helicopter Landing Officer
Civil Aviation Authority Marine Operators Certificate
Personal Safety & Social Responsibilities
Specialised Tanker Training (Oil)
Specialised Tanker Training (Chemical)
Specialised Tanker Training (Liquid Gas)
Crude Oil Washing
Inert Gas Plant
Dangerous Goods by Sea (IMDG)
Ship Safety Officer
Ship Security Officer
Ship Security Officer (ISPS)
Behavioural Safety Awareness
Safety Awareness/Accident Prevention
Abrasive Wheel Regulations
Welding
Crowd Management
Crisis Management & Human Behaviour
Passenger Safety, Cargo Safety & Hull Integrity
Efficient Deck Hand
Train the Trainer
Any other Relevant Training  


Previous Employment
Job Description 1:     Job Description 2:  
Dates: From-To Dates: From-To
Position:   Position:
Company:   Company:
Vessel Type:   Vessel Type:
Reason for Leaving:   Reason for Leaving:

Job Description 3:     Job Description 4:  
Dates: From-To Dates: From-To
Position:   Position:
Company:   Company:
Vessel Type:   Vessel Type:
Reason for Leaving:   Reason for Leaving:

Other (Please list any other previous employment in the box below):

Sea Service Details
Description 1:     Description 2:  
Company Name: Company Name:
Rank:   Rank:
Vessel Name:   Vessel Name:
Signed On:   Signed On:
Signed Off:   Signed Off:
Vessel Type:   Vessel Type:
G.R.T   G.R.T
D.W.T   D.W.T
Engine Type   Engine Type
BHP   BHP
KW   KW

Description 3:     Description 4:  
Company Name: Company Name:
Rank:   Rank:
Vessel Name:   Vessel Name:
Signed On:   Signed On:
Signed Off:   Signed Off:
Vessel Type:   Vessel Type:
G.R.T   G.R.T
D.W.T   D.W.T
Engine Type   Engine Type
BHP   BHP
KW   KW

Other (Please list any other previous Sea Service details in the box below):


Reference Contact Details
Reference 1:     Reference 2:  
Company Name: Company Name:
Address:   Address:
Phone No.:   Phone No.:
Email:   Email:
Contact Person:   Contact Person:

Reference 3:        
Company Name:    
Address:      
Phone No.:      
Email:      
Contact Person:      

Date available for employment?
What notice do you require for an interview?
May we contact your present employer for a reference? yes no
Have you ever left a company other than voluntarily? yes no

Medical  
 
Date of last medical examination (ENG1)?
Do you have any current health problems? yes no
If yes, give details:
Please list any significant illness or injury for which you have consulted a doctor:

Why do you want to join Maersk?
Please add any reasons which you'd like us to consider with your application:


Have you ever been arrested or convicted of any crime or offence or have any pending offences?

yes no (If yes, input details below)

 

I confirm that I have answered all the questions in this online application to the best of my knowledge and have omitted nothing of importance regarding my health:
Please click box to confirm: