SAKR MANNING AGENCY Issue Date 15.05.
2022
FOR RECRUITING EGYPTIAN LABOR ABROAD Revision Date 01.02.2024
Crewing Management Manual Revision 1.3
Seafarer Employment Application Page 4
Application For Position as
Register Code.
Other Position (If Any)
Register Date
Last up Date Data
Expected Salary / Available Date
1. PERSONAL DETAILS
Full Name
Married Single Marital Status Date Of Birth
Weight (Kg) Height (Cm) Nationality
Shirt Size Overall Size Place Of Birth
Shoes Size Trouser Size Nearest Port
2. EDUCATION
College / School
Issued At Issued By (Authority) Result % Issued Date Marline Test
Poor Average Good Fluent English Language
Poor Average Good Fluent ……… Language
3. CONTACT DETAILS
Home Address / City
M E-Mail
4. TRAVEL DOCUMENTS o
Place of Issue ISS. By (Authority) Exp. Date ISS. Date Document No. Type
Egyptian Authority Passport
Alex. EAMS Seaman Book
Other Seaman Book
5. PROFESSIONAL QUALIFICATION / CERTIFICATE OF COMPETENCY
Issued At Issued By Expiry Date Issue Date Number Certificate Name
Alex. EAMS COC ( Rank) …………..
Cairo NTRA GOC
6. NEXT OF KIN / EMERGENCY CONTACT
Relationship Full Name
Address / Country
Email Tel. No./ Mobile
7. HEALTH CERTIFICATES & VACCINATIONS
Issued At Issued By Expiry Date Issue Date Number Flag State
Alex. EAMS International Medical
Ministry of Health Yellow Fever
Ministry of Health Cholera
Second Dose First Dose Vaccination Name
(Other Does or Remarks) Covid-19
8. MARINE COURSES
1 of 4 SMA/CMF/01
Issued By / At Expiry Date Issue Date Number Course Name
Personal Survival Techniques
Proficiency In Personal Survival Techniques
Fire Prevention and Fire Fighting
Advanced Fire Prevention and Fire Fighting
Elementary First Aid
Medical Care Studies
Personal Safety and Social Responsibilities
Proficiency Of Security Awareness Training Seafarers
Proficiency as a ship Security officer ( PSSO )
Proficiency In Survival Craft & Rescue Boats
G.M.D.S.S
Communications
Advanced Communications
ECDIS Advanced Simulator (Management Level)
ECDIS Simulator (Operation Level)
Prevention and Combating of Marine Pollution
Radar & ARPA Simulator and Search &rescue
ARPA Simulator and Search
Marine Radar and automatic Radar Plotting
Bridge resource Management (B.R.M)
Engine resource Management (E.R.M)
Navigational Watch keeping
EAMS / Alex. Proficiency for Rating forming part of Navigational watch (II/4)
High voltage training – operation of ship (1000 Volt and More)
Passenger Safety Cargo Safety and Hull integrity
Crowd Management Training
Crisis Management and Human Behavior Training
Safety training for Personal Prov. Direct Passengers
Practical Ability to Prepare Meals and (MLC 2006)
Personal Hygiene and Envir. Protection (MLC 2006)
Safety and Health in the Provision Meals (MLC 2006)
Food Storage and inventory Control (MLC 2006)
EAMS / Alex. Ships Cook Certificate (MLC 2006)
Abel Seafarer Deck
EAMS / Alex. Proficiency for Abel Seafarer Deck ( II/5 )
EAMS / Alex. Engineering Watch keeping
Proficiency for Rating forming part of a watch in engine room
Abel Seafarer Engine
EAMS / Alex. Proficiency for Abel Seafarer Engine ( III/5 )
Electro Technical Rating
EAMS / Alex. Proficiency for Electro Technical rating ( III/7 )
D.p. induction/ d.p. advanced
D.p. operator (unlimited)
Others
2 of 4 SMA/CMF/01
9 - COMPLETE SEA – SERVICE DETAILS
Register Code: Rank: Name:
Reason Vessel
for Sign Engine D.W.T./
BH/ KW Vessel Type Period Signed Off Signed On Flag Name/IMO Rank Company Name
off Type G.R.T
Number
10. REFERENCES
3 of 4 SMA/CMF/01
EMAIL TEL Company / Management / Country No
Name Position
11. DECLARATION
Please answer the following questions:
Did you suffer, or presently suffer from, any disease likely to render you unfit for
services at sea or likely to endanger the health of other persons on board?
YES NO If yes, please provide details _______________________________________________
______________________________________________________________________
YES NO Did you suffer any accident, which rendered you temporary and/or partially
disabled?
YES NO Did you ever undergo psychiatric treatment
YES NO Are you addicted to alcohol or drugs of any kind?
I hereby declare that the above facts and information are true and accurate. I further consent to the holding and processing by (i) the owners of any vessel
on which I may be assigned from time to time and (ii) the Managers and any direct or indirect parent or subsidiary or associated or affiliated company of the
Managers (together referred to as "the Companies") for the purposes of my employment, of personal data about me contained herein, or provided to any of
the Companies at a later date, including with respect to personal and pensions administration, employee management and as required to comply with any
laws, regulations or contracts applicable to any of the Companies or their businesses. I understand that this data will be stored in the Managers’ database for
the purposes of my current or future employment arranged by the Managers. Further, I confirm that the above may involve the transfer of my personal data
within the Managers’ organization.
Place___________________________ Date ___________________________ Signature ______________________________
[Link] Office Use Only
Initial assessment of applicant for further recruitment
Comments
Responsible person
Name / Signature _______________________________________________ Date ________________________________
4 of 4 SMA/CMF/01
