CREW PROFILE FORM
Thank you for joining our team! As you will soon be boarding the Sea Dragon we need some information from you for a smooth voyage.
CONTACT DETAILS *
Your answer
Address Line 1
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Address Line 2
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City
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State/County
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Trip *
Select your voyage
Zip/Post Code
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Country
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Email
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Phone Number
No formatting please! For example: 19204121234
Your answer
How did you find out about Pangaea Exploration / this expedition?
Please be as specific as possible
Your answer
Passport Details
Full Name as written on passport (first, middle, given/last name/surname)
Your answer
Passport Number
Your answer
Nationality
Your answer
Date of Birth
Format: dd-Mmm-yyyy For Example: 22-Jan-1985
Your answer
Date of Issue
Format: dd-Mmm-yyyy For Example: 22-Jan-1985
Your answer
Date of Expiry
Format: dd-Mmm-yyyy For Example: 22-Jan-1985
Your answer
Sex
Emergency Contact/Next of Kin
Name
Your answer
Emergency Contact Relationship
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Emergency Contact Home Phone Number
No formatting please! For example: 19204121234
Your answer
Emergency Contact Mobile Phone Number
No formatting please! For example: 19204121234
Your answer
Emergency Contact Email Address
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Arrival Date, Time, and Flight Number
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Departure Date, Time, and Flight Number
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Please check if you require visas for departure and/or arrival ports
(if yes) Approved visa number
Your answer
Practical Information
Dietary requirements and food allergies
Your answer
Maritime training/experience (if any)
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Medical Conditions
Please remember offshore sailing can be a strenuous activity and you will be a long way (many days) from medical help. There is a separate comprehensive medical history form to fill out but please use this box to tell us if there is an ongoing health concern we should discuss beforehand. Thanks.
Your answer
Can you swim? *
PUBLIC PROFILE
This information will be distributed to the team and posted on the Pangaea Exploration website
Background and area of expertise
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Goals and aims for the expedition
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SEND US A PICTURE OF YOU
As soon as you submit this form please send a head and shoulders photo of yourself to info@panexplore.com
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