PERSONAL DATA
* FIRST NAME : * SURNAME :
PRESENT RANK : SINCE DATE :
DATE OF READINESS : SALARY EXPECTED (EURO) :
* BIRTH DATE : BIRTH PLACE :
NATIONALITY :
EYES : HAIR :
HEIGHT(cm) : WEIGHT(kg) :
CIVIL STATUS : CHILDREN :
FATHER NAME : MOTHER NAME :
HOME ADDRESS
STREET :
ZIP CODE : CITY :
COUNTRY : CLOSEST AIRPORT :
* PHONE : FAX
MOBILE : E-Mail
PRIMARY ADDRESS
FOREIGN LANGUAGES
LANGUAGE : LANGUAGE SKILL :
EDUCATION
SCHOOL'S NAME FROM TILL DEGREE REMARKS
1
DOCUMENTS
COUNTRY NUMBER ISSUED PLACE OF ISSUE ISSUED BY EXPIRES
PASSPORT
SEAMAN BOOK
SEAMAN BOOK 2
SEAMAN BOOK 3
HEALTH CERTIFICATE
HEALTH CERTIFICATE(2)
HEALTH CERTIFICATE(3)
MCV VISA
SCHENGEN VISA
OTHER VISA
D&A TEST
YELLOW FEVER
US VISA
CERTIFICATES OF COMPETENCY
CAPACITY COUNTRY NUMBER ISSUED PLACE OF ISSUE EXPIRES
LICENCE
ENDORSEMENT
OTHER ENDORSEMENT :
STCW - 78/95 CERTIFICATES
COUNTRY NUMBER PLACE OF ISSUE ISSUED EXPIRES
ARPA
SHIP SECURITY AWARENESS
SEAFARERS WITH DESIGNATED SECURITY DUTIES
BASIC SAFETY TRAINING (4 IN 1)
PERSONAL SURVIVAL TECHNIQUES
PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES
ELEMENTARY FIRST AID
FIRE FIGHTING
MEDICAL FIRST AID
MEDICAL CARE
ADVANCED FIRE FIGHTING
PROFICIENCY IN SURVIVAL CRAFT AND R. B.
SHIP SECURITY OFFICER
GMDSS GENERAL OPERATOR
GMDSS ENDORSEMENT
HAZMAT
BRIDGE TEAM MANAGEMENT
DP BASIC
DP ADVANCED (SIMULATOR)
DP OPERATOR (FULL)
BOSIET
HUET
FAST RESCUE BOATS
LOW VOLTAGE CERTIFICATE TO 1 KV
HIGH VOLTAGE ON SHIPS CERTIFICATE
BRIDGE RESOURCE MANAGEMENT
ARPA MNGMT LEVEL
DP MAINTENANCE
ECDIS
SHIP HANDLING
RIGGING & SLINGING COURSE
CRISIS MANAGEMENT ON PASSENGER SHIPS
CROWD MANAGEMENT ON PASSENGER SHIPS
H2S TRAINING
SAFETY TRAINING ON PASSENGER SHIPS
ENGINE ROOM RESOURCE MANAGEMENT
SEA SERVICE (LAST 5 YEARS)
CREWING AGENCY SHIP'S OWNER VESSEL'S NAME FLAG PERIOD FROM PERIOD TO VESEL'S TYPE/GRT ENGINE TYPE/BHP TEU YEAR OF BUILD RANK
1
REFERENCES (OPTIONAL)
NAME OF COMPANY
/CREWING AGENCY 		PHONE NUMBER E-mail CONTACT PERSON
1
ADDITIONAL INFO:

Na podstawie Rozporządzenia Parlamentu Europejskiego i Rady (UE) 2016/679 z dnia 27 kwietnia 2016 r. w sprawie ochrony osób fizycznych w związku z przetwarzaniem danych osobowych i w sprawie swobodnego przepływu takich danych oraz uchylenia dyrektywy 95/46/WE, oświadczam że wyrażam dobrowolną zgodę na przetwarzanie przez Romor PHU S.C. (z siedzibą w Gdańsku, ul. Trzy Lipy 4/3, 80-172 posiadającą certyfikat nr 10755, NIP 9571070582), która będzie administratorem danych osobowwych) moich danych osobowych podanych w aplikacji dla celów obecnych i przyszłych rekrutacji i pośrednictwa pracy u armatora zagranicznego, w tym do celów niezbędnych do realizacji marynarskiej umowy o pracę.

In accordance with REGULATION (EU) 2016/679 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (GDPR) I hereby freely give consent for my personal data included in the application form to be processed by ROMOR PHU S.C. (with its seat in Gdansk, 80-172 Poland, Trzy Lipy 4/3 street, holding certificate no 10755, VAT no PL9571070582), for the purposes of the rercruitment, placement & maritime job matching services.