Global Supercargoes Application Form- (GS15/001)
Application Form for Prospective Candidates Addition to Globalsupercargoes.com Network-**Please note that all applications will be vetted by the managing partners of Globalsupercargoes.com .Globalsupercargoes.com reserves the right to refuse final entry on approved consultants list. Globalsupercargoes.com is equal opportunities and non-discriminatory group**
Biographical data
Who you are, where you live and how to contact you.
Last Name *
As per Passport
Your answer
First and Middle Name *
As per Passport
Your answer
First and Middle Name *
As per Passport
Your answer
Preferred Name *
What do you want to called?
Your answer
Skype Name *
Please give contact details on how we can contact you on Skype?
Your answer
e-mail address *
Your answer
Phone number *
Please supply in international format starting with '+' (ITU's E.123 format)
Your answer
Country of Residence *
Where do you live?
Your answer
City of Residence *
Name the city where you live?
Your answer
Other Countries where you can legally work/domicle without a visa? *
Please indicate if you have dual citizenship?
Next-of-kin Information *
Please supply name, relationship, address, phone numbers and e-mail of a person that we can contact in case of emergency?
Your answer
Work Experience, Skill Sets and Interests
We need this information to correctly place you on prospective jobs, as and when they come up.
Rank served *
Please indicate highest serving rank on Chemical tankers?
COC Qualifications *
What license do you hold?
COC Qualifications- Date *
Date license/certificate of competency was issued?
MM
/
DD
/
YYYY
COC issuing Country *
Country which issued your STCW licence?
Your answer
MLC Compliant Medical Certificate *
Do you hold a medical certificate to comply with MLC requirements? (Seaman's Medical such as MCA ENG1 or similar?)
MLC Compliant Medical Certificate-Date
Date of expiry of seaman's medical certificate? (if applicable)
MM
/
DD
/
YYYY
College Qualifications *
What is the highest degree/diploma attained? From which college?
Your answer
College Attended *
Last college attended where Diploma/Degree was issued?
Your answer
College Qualifications-Date *
Date of graduation?
MM
/
DD
/
YYYY
Do you hold a valid TWIC Card? *
US Transport Workers Identification Credential.
Areas of Expertise/interest *
What type of jobs would be suitable basis your skill set and experience?
Required
Other Qualifications/Work Experience
Please list what qualifications you have and detail work experience you have that match you with your area of Expertise/Interest?
Your answer
References *
Please supply three professional contactable references who can verify your good character and professional credentials?
Your answer
Availability
Please indicate dates of your availability to work with us on a contractual basis?
Any changes to availability subsequent to completing this form please notify globalsupercargoes.com via e-mail
Your answer
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