DGS - agencija za obavljanje poslova posredovanja pri zapošljavanju pomoraca

Aplikacija za kandidate

Prijava u DGS bazu pomoraca

Molimo vas da pročitate upute prije ispunjavanja Aplikacije

UPUTE

Ispunite što više polja budući da bi nam svaka informacija mogla biti vrlo korisna.
Ako ste već ispunili Aplikaciju, kontaktirajte nas da vam pošaljemo korisničke podatke za prijavu i izmjene dokumenta.
Obavezna polja su ona označena zvjezdicom (*). Ako se obavezno polje ne odnosi na Vas, molimo da upišete X.
Aplikacija se sastoji od 5 koraka i ne možete prijeći na sljedeći dio prije nego ispunite sva obavezna polja u onom prethodnom.

FORM STEP:

step 1/5PERSONAL INFORMATION

Personal Details
Family Name
Given Name(s)
Place of Birth
Date of Birth
RANK / OCCUPATION (*)
Height (cm)
Weight (kg)
Color of Eyes
Hair Color
Gender
Marital Status
Number of Children
 
Willing to accept lower rank?
Date available to start work
Desired contract type
Desired contract dynamics
Home Address
Street address
Zip Code / City
Country (*)
Phone
Mobile Phone
E-mail
Nearest Airport
Education
QUALIFICATION
NAME OF SCHOOL FINISHED
FROM (Year)
TO (Year)
TYPE OF DEGREE OR DIPLOMA

step 2/5PERSONAL INFORMATION

Travel documents and Medical Examination
Country of Issue
Number
Place of Issue
Date of Issue
Date of Expiry
Passport
 
Place and Country of Issue
Control Number
Date of Issue
Date of Expiry
US Visa
 
Country of Issue
Number
Place of Issue
Date of Issue
Date of Expiry
Seaman's Book
 
Date of examination
Date of Expiry
Place of Issue
Health certificate issued by
Health Certificate
 
Place and Country of Issue
Lot number
Date of Issue
Date of Expiry
Yellow Fever (vacc.)
Medical History
All previous illnesses, except minor ailments, should be written below or updated. If not previously stated, the Company (employer) has the right to decline any reimbursements of medical expenses, claims for treatment or for any other insured benefits.
 
I. Have you ever disembarked a ship due to medical reasons?
If yes, please complete the following details (if you require more space, attach additional sheets):
Name of vessel
Date of occurrence
Place of occurrence
 
Short description of illness / accident / injury
 
II. For what illnesses or accidents have you consulted a doctor in the past 12 months?
Details of illness / accident
Date
Treatment / Therapy
 
III. Please provide details for any health problem or disability you have

step 3/5CERTIFIED COMPETENCIES

Certificate of Competence (COC)
Main Certificate of Competence
Country of Issue
Identification Number
Place of Issue
Date of Issue
Date of Expiry
General Operator Certificate (GOC)
Name of Certificate
Country of Issue
Identification Number
Place of Issue
Date of Issue
Date of Expiry
GMDSS (IV/2)
FURTHER CERTIFICATES / COURSES COMPLIANT WITH STCW '95 (amended in 1995)
Name of Certificate / Course
Country of Issue
Identification Number
Place of Issue
Date of Issue
Date of Expiry
SHIP SECURITY OFFICER (SSO) (VI/5)
HAZMAT (B-V/4,V/5)
BASIC TRAINING (VI/1)
SURVIVAL CRAFT AND RESCUE BOATS (VI/2)
ADVANCED FIRE-FIGHTING (VI/3)
MEDICAL FIRST AID (A-VI/4-1)
ADVANCED MEDICAL CARE (VI/4)
ECDIS
MARITIME ENGLISH TEST

step 4/5CERTIFIED COMPETENCIES

Foreign Endorsments / Seaman's Books
Identification Number
Date of Issue
Date of Expiry
SEAMAN`S BOOK
COC ENDORSEMENT
GMDSS ENDORSEMENT
Identification Number
Date of Issue
Date of Expiry
SEAMAN`S BOOK
COC ENDORSEMENT
GMDSS ENDORSEMENT
PREVIOUS SEA SERVICE
VESSEL`S NAME
FLAG
RANK
TYPE OF VESSEL
ENGINE TYPE
COMPANY
GT or KW
FROM DATE
TO DATE
SIGN OFF REASON

step 5/5ADDITIONAL INFORMATION

Next of Kin
Name
Family Name
Relationship
same as Home address
Street address
Phone
City (Zip Code)
Country
General
I. Have you ever been denied a foreign visa?
If yes, provide details about the country and reason (if known)
 
II. Have you ever been the subject of a court inquiry or involved in a maritime accident?
If yes, please provide details as attachment
 
III. Please provide information below for 2 recent employers who we may contact for references:
Reference 1
Reference 2
Name of Company
Name of contact person
Address
Country
Telephone
Remarks
My photo (jpeg,jpg)
Signature