Job Application Form
154 Connell Rd Fishermans Wharf, Geraldton, Western Australia 6530 T: +61 8 9965 9700 E: [email protected] W: www.bhagwanmarine.com
Section 1 – Details of Applicant
Title Mr Mrs Miss Ms Full Given Name(s) Surname
Preferred Name Gender Date of Birth
Male Female
Phone Number Email Address
Residential Address City/Suburb/Town State Postcode
Country
Tick if Postal Address same as above
Postal Address City/Suburb/Town State Postcode
Country
Section 2 – Work Experience of Applicant
Are you currently authorised to work in Australia? Do you have previous marine experience?
Yes No
154 Connell Rd Fishermans Wharf, Geraldton, Western Australia 6530 T: +61 8 9965 9700 E: [email protected] W: www.bhagwanmarine.com
Relevant Marine Experience #1
Company Name Employment Date
From To
Project Name Project Location
Oil and Gas Project? Vessel
Yes No
Main Duties and Responsibilities
Relevant Marine Experience #2
Company Name Employment Date
From To
Project Name Project Location
Oil and Gas Project? Vessel
Yes No
Main Duties and Responsibilities
154 Connell Rd Fishermans Wharf, Geraldton, Western Australia 6530 T: +61 8 9965 9700 E: [email protected] W: www.bhagwanmarine.com
Relevant Marine Experience #3
Company Name Employment Date
From To
Project Name Project Location
Oil and Gas Project? Vessel
Yes No
Main Duties and Responsibilities
Relevant Marine Experience #4
Company Name Employment Date
From To
Project Name Project Location
Oil and Gas Project? Vessel
Yes No
Main Duties and Responsibilities
154 Connell Rd Fishermans Wharf, Geraldton, Western Australia 6530 T: +61 8 9965 9700 E: [email protected] W: www.bhagwanmarine.com
Relevant Marine Experience #5
Company Name Employment Date
From To
Project Name Project Location
Oil and Gas Project? Vessel
Yes No
Main Duties and Responsibilities
Relevant Marine Experience #6
Company Name Employment Date
From To
Project Name Project Location
Oil and Gas Project? Vessel
Yes No
Main Duties and Responsibilities
154 Connell Rd Fishermans Wharf, Geraldton, Western Australia 6530 T: +61 8 9965 9700 E: [email protected] W: www.bhagwanmarine.com
Position Sought (tick what is applicable)
Master Mate/Chief Officer
Chief Engineer
First Engineer
Able Seaman/Deckhand
Chef/Cook Steward
Maritime Qualifications (tick those that are applicable)
Master Class 3 and Masters <500GT
Master Class 4 Trade
Master Class 5 Trade
Engineer Class 3 (Motor)
Marine Engine Driver Grade 1 (MED 1)
Marine Engine Driver Grade 2 (MED 2)
GMDSS AMSA Certificate of Medical Fitness
STCW95 – AMSA Certificate of Safety Training
Maritime Security Identification Card (MSIC)
Helicopter Underwater Escape Training (HUET)
Tropical Basic Offshore Safety Induction & Emergency Training (TBOSIET)
High Risk Work Licenses (tick those that are applicable)
Dogging Basic Rigging Intermediate Rigging
Advanced Rigging Vehicle LoadingCranes
Other Certificates/Qualifications (tick those that are applicable)
Cooking – Trade Certificate
OHS Construction Induction Card
Senior First Aid (HLFA301B Apply First Aid)
154 Connell Rd Fishermans Wharf, Geraldton, Western Australia 6530 T: +61 8 9965 9700 E: [email protected] W: www.bhagwanmarine.com
Reference 1
Full given name(s) Surname
Company Position
Phone number Email address
Reference 2
Full given name(s) Surname
Company Position
Phone number Email address
Reference 3
Full given name(s) Surname
Company Position
Phone number Email address
Instructions on sending this form
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