sea chefs River Cruises Ltd
Interview No: / Crew I.D.: /
Position applied for: / Department: / Date:
PERSONAL / Surname: / First Names:
Age / Sex:
Present Address: / Mobile Telephone No:
Permanent Address: / Home Telephone No:
E-mail address:
Date and Place of Birth: / Nationality:
Passport No: / Issue date: / Issue place: / Expiry date:
Seamans Book No: / Issue date: / Issue place: / Expiry date:
Marital status: / Relationship:
Next of Kin: / Address:
Telephone No:
Present Employment: / Since when:
Ever applied to this Company before? / When?
Recruitment Agency: / Main departure airport:
Have you ever had any difficulties with the authorities, (i.e. Police, Customs, Immigration etc.)? If so, for what reasons?
EMPLOYMENT
HISTORY / Position: / Name and Address of Employment: / From – To (Dates): / Reason for Leaving:
LANGUAGES / Spoken / Written / Reading
Fair / Well / Excellent / Fair / Well / Excellent / Fair / Well / Excellent
ENGLISH
GERMAN
FRENCH
ITALIAN
SPANISH
RUSSIAN
OTHER:
EDUCATION / Education / Name and Place of School / Years Attended / Year Graduated
High School
College
Trade, Business
or Other School
DIPLOMAS/CERTIFICATES / Diploma / Certificate / No. / Date of Issue / Expiry Date / Duration of Training
Basic Safety Training
Section (A-VI/1.2)
Section A-V/2 (par. 1,2,3,4,5) (state which paragraphs)
Section A-V/3 (par. 1,2,3,4,5) (state which paragraphs)
Crowd Management
Crisis Management
VISA / USA (C1/D1) / Issue date: / Issue place: / Expiry date:
SCHENGEN / Issue date: / Issue place: / Expiry date:
MEDICAL / Are you currently under a doctor’s care with medication? / YES / NO
If yes please specify:
Do you have any recurring medical problems? / YES / NO
If yes please specify:
Are you on any medication? / YES / NO
If yes please specify:
Do you have any physical and/or mental condition that would limit your ability to perform the job you are seeking?
Height : / Weight:
State if any defect in:
Hearing:
Vision:
Speech:
I confirm that the above is to the best of my knowledge and belief correct.
I also understand that any false statement above is reason form dismissal if engaged.
Date: / Signature of applicant:Please attach a copy of the following documents:
No / Documents / √ / Expiry / (Comments)
1. / Passport (photo, name, expiry and visa pages)
2. / Seaman’s Book
3. / Vaccination Book
4. / Qualification Certificates
5. / Training Certificates
INTERNAL USE ONLY / To be completed by the interviewer:
Name of interviewer: / Date: / Suggested Positions
Languages: / ENG: / FR / GER: / GR: / ITA: / SPN:
Evaluation Criteria: / Comments: / 1
Appearance: / 2
Experience: / 3
Knowledge: / 4
Suggested Vessels
Overall Evaluation: / 1 / 2 / 3 / 4 / 5 / 1
Poor / Fair / Good / Very Good / Excellent / 2
Interview outcome: / Passed –
Contract offered / Passed –
Stand by Contract offered / Passed –
No offer / Failed / 3
Signature of Interviewer :
Issue: 1/ Issue date: 1-11-2012/ 2/2