Test offshore application form

Personal data / Date personale

First name / Prenume*:

Last name / Nume de familie*:

Mobile phone / Telefon mobil*:

Mobile Phone 1 / Telefon mobil 1:

Email / Email*:

Address / Adresa*:

City / Oras*:

Place of birth / Locul nasterii*:

Date of birth / Data nasterii*:

Graduated / Absolvit:

Next of kin's first name / Prenume persoana de contact*:

Next of kin's last name / Nume de familie persoana de contact*:

Relationship with the next of kin / Relatia cu persoana de contact*:

Next of kin's phone / Telefon persoana de contact*:

Next of kin's address / Adresa persoana de contact*:

Next of kin's city / Oras persoana de contact*:

Next of kin's date of birth / Data de nastere a persoanei de contact:

Mother's name/ Numele mamei*:

Father's name/ Numele tatalui*:

Hair color / Culoare par:

Eye color / Culoare ochi:

Height(cm) / Inaltime(cm):

Weight(kg) / Greutate(kg)*:

Rank / Functie:

Qualification / Calificare*:

Coverall size / Dimensiune uniforma*:

Shoe size / Dimensiune pantofi*:

Sex:
M
F

Married / Casatorit:
Yes/Da
No/Nu

Upload photo(.jpg/.jpeg/.png) / Adaugati o poza(.jpg/.jpeg/.png):

Courses / Cursuri

Course #1 / Curs #1

Course type / Curs:

Issued date / Emis la data:

Expiry date / Expira la data:

Number / Numar inregistrare:

Documents / Documente

Document #1

Document type*:

Issued date*:

Expiry date*:

Series*:

Issued at*:

Experience / Experienta

Experience #1 / Experienta #1

Sign on / Inceput la data*:

Sign off / Finalizat la data*:

Company/Shipyard:

Drilling vessel/Rig:

Rank / Functie*:

Describe responsabilities / Descrieti responsabilitatile*:

Politica de confidentialitate

I have read and I agree with the privacy policy above / Am citit si sunt de acord cu politica de confidentialitate