Qualified Maritime Officer Application Form

For general enquiries, please contact SSML Recruitment.

This form will take approx 5 to 10 minutes to complete. Please complete this form as fully as possible.

Fields marked by * are mandatory

2. Position applied for *

   Position applied for *

   Deck Officer
   
   Engineer Officer
   
   

3. Personal Details

5. Title

   Mr Miss Mrs Ms Captain
6. Surname *

7. Fornames & Initials *

8. Gender *

   Male Female
9. Age *

10. Date of birth *

11. Place of birth *
12. Nationality

13. Current Rank *

14. Marital Status

    Single Married Divorced Separated
15. Number of Dependants *

    0 1 2 3 4 or more

16. Contact Details

17. Telephone Number inc Country and STD Code *

18. Valid Email Address

19. Fax Number

20. Current Address *

21. Full Time Address if different from above
22. Nearest Rail Station *

23. Nearest Airport *

24. Next of Kin Details

25. Title *

    Mr Miss Mrs Ms Other
26. Surname *

27. Forenames & Initials *

28. Relationship of Next of Kin *

29. Date of Birth *

30. Next of Kin Contact Details

31. Permanent Address *
32. Telephone Number inc STD Code *

33. Other Contacts email fax etc

34. Documentation

35. Please complete this section as fully as possible.

36. Discharge Book Number *

37. Passport Number *

38. Passport Country of Issue *

39. Passport Date of Issue *

40. Passport Expiry Date *

41. Seafarers Medical Certificate Country of Issue *

42. Seafarers Medical Certificate Expiry Date *

43. US Visa C1D Expiry Date

44. Flag State Certificates Held if any

45. Isle of Man

46. Bermudian

47. Bruneian

48. Singaporean

49. Malaysian

50. STCW 95 Certification

51. You must be in possession of a valid STCW 95 Certificate of Competency/license for your application to be considered.

52. Grade or Class of Certificate *

53. Certificate Number *

54. Country of Issue *

55. Issue Date *

56. Revalidation or Expiry Date *

57. Dangerous Cargo Endorsement

58. For the pupose of candidate selection, it is preferable to be in possession of a Dangerous Cargo Endorsement.

    Type or Level

59. Oil

60. Gas

61. Level 1

62. Level 2

63. Endorsement Numbers

64. Country or Countries of Issue

65. Issue Dates

66. Revalidation or Expiry Dates

67. Vaccination Expiry Date

68. Typhoid

69. General

70. Are you a member of the Reserved Armed Forces? *

    Yes No

71. Education History

72. Name and Address of Schools and Colleges attended *

73. Qualifications

74. Please give details of examinations passed and certificates or grades obtained.

75. Qualifications *

76. Cadetship or Apprentiship Details

77. Date Commenced

78. Date Completed

79. College and or Training Centre Attended
80. Country

81. Sponsoring and or Training Company

82. Practical Experience

83. Please check if you have experience of any of the following...

84. Crude Oil/Product Cargoes

85. LNG/LPG Cargoes

86. Multi-grade Cargoes

87. Submerged Cargo Pumps

88. Stripper/Eductor Systems

89. Ship-to-Ship Transfer

90. Auto Ullage/Sounding Gauges

91. Remote Pumps/Valves

92. COW Systems

93. Hot/Cold Washing

94. Integrated Bridge Systems

95. ECDIS Charts

96. Deck Cranes/Derricks

97. Hydraulic Winches

98. Steam Winches

99. Dry Docking

100. Steam Plant Operations

101. Diesel Engines

102. Bridge Control Systems

103. Computerised Engine Management DCS

104. UMS Operations

105. Gas/Electric Welding

106. Instrument Air Systems

107. Hydraulics

108. High Voltage (DC/AC) Power Plants

109. Fire Detection Systems

110. Electronics

111. Switch Gear

112. Air Compressors

113. Automation

114. Other Practical Experience, please specify...
115. Have you previously been involved in a major fire or collision? *

     Yes No

116. Please give brief details...

117. Short Course Training History

118. Please give details of any short courses that you have taken together with the dates completed. e.g. Personal Survival, DP, VCI.

119. Short Course Details *

120. Employment History (including Armed Forces)

121. 	Please provide details of up to the last 3 vessels on which you have served. Further details may be requested by our Officer Recruitment Team.			Most Recent Vessel

122. Employer, Rank, Name of Vessel, Type of Vessel, Size, Engine Type, Date From, Date To: *

123. 2nd Vessel

124. Employer, Rank, Name of Vessel, Type of Vessel, Size, Engine Type, Date From, Date To:

125. 3rd Vessel

126. Employer, Rank, Name of Vessel, Type of Vessel, Size, Engine Type, Date From, Date To:

127. Supporting Details

128. Are you currently serving under a contract? *

     Yes No
129. What period of notice do you require to attend an interview?

130. From what date are you available for sea service?

131. May we approch you current employer for a reference?

     Yes No
132. May we approach your past employers for a reference? *

     Yes No

133. Referees

134. Please provide details of up to two referees (name, address, job, contact details)

135. Background to Application

136. Please state briefly what prompted you to make this application

137. Where did you hear about careers with Shell Shipping?

138. The following information will not be used as part of the selection process.

139. Your Custom *

     Newspaper/Magazine Advert (Please Specify) School/College/Uni Careers Office Friend/Family/Shell Employee Internet Search (Please specify site)

140. (internet Search) Please Specify

141. Ethnicity

142. Completion of these questions is entirely voluntary and for the purposes of assisting us to monitor our standard of diversity and inclusiveness.

     The following information will not be used as part of the selection process. It will be controlled by Shell Ship Management Limited and reported on an anonmymous basis only.

143. What is your ethnic origin?

     White Black African Black Caribbean Far Eastern Middle Eastern Other
144. If "Other" please specify...

145. 			Our Company is committed to the principle of Equal Opportunity in employment. We oppose any form of less or more favourable treatment being accorded to employees or job applicants on the basis of their colour, disability, ethnic origin, gender, nationality, marital status, race, religion, sexual orientation or gender reassignment.