Rom Trust S.R.L. Form F-01-1 - APPLICATION FOR EMPLOYMENT (rev.2 / 20.02.

2014)
SC ROM TRUST SRL prelucreaza datele cu caracter personal furnizate de dvs. prin acest document in scopul prezentarii candidaturii dvs. pentru o posibila angajare. Datele vor fi dezvaluite numai
potentialilor angajatori. Pe viitor, aceste date ne permit sa va tinem la curent cu activitatea noastra. In cazul in care nu doriti aceasta, nu va vom putea lua in considerare aplicatia si nu va vom
inregistra in baza noastra de date. Conform Legii nr.677/2001, beneficiati de dreptul de acces, de interventie asupra datelor, dreptul de a nu fi supus unei decizii individuale. Aveti dreptul sa va
opuneti prelucrarii datelor personale care va privesc si sa solicitati stergerea datelor din baza noastra de date. Pentru exercitarea acestor drepturi, va puteti adresa cu o cerere scrisa, datata si
semnata la sediul nostru. De asemenea, va este recunoscut dreptul de a va adresa justitiei. Datele dvs. vor fi transferate in statele Uniunii Europene in vederea unei posibile angajari.
Număr Registrul General Autoritatea Nationala de Supraveghere a Prelucrarii Datelor cu Caracter Personal: 22497.

Family Name: Given Name:

Date and Place of birth:
Height (m): Weight(kg): Overall size: Shoes size:
Wear glasses? Yes/No Dioptric left eye: Dioptric right eye:
Father’s Name: Mother’s Name: photo
Education: Between years: Rank/Rating:
Home address:
Phone no.1: Phone no.2 : E-mail:
Language proficiency (delete as appropriate) English: working good fluent Other working good fluent
language:
MARITAL STATUS: NEXT OF KIN: Family name: Given name:
Date/Place of birth: Relationship: Phone no.:
Children’s Name
Date of birth
PERSONAL DOCUMENTS No. Place issued Date issued Valid / Endorsed until
National I.D. Card
Seaman’s Book
Passport
USA Visa
Australian MCV
Certificate of competency:
Rank & Number
Endorsement
I . M. O . S T C W 7 8 / 9 5 C E RTI F I C ATE S
C e r t i f i ca t e Nr. Date issued Certificate Nr. Date issued
Personal survival techniques Proficiency in fast rescue boats
Basic fire-fighting Tanker familiarization
Medical first aid Specialization in oil tanker
P.S.S.R. Specialization in chemical tanker
Prevention of pollution MARPOL 73/ 78 Specialization in gas tanker
Transport & handling dangerous, hazardous cargoes Bridge/Engine Team & Resource Management
Maritime English Ship’s Handling & Manoeuvring
Proficiency in survival craft& rescue boats ECDIS
Advanced fire-fighting Bridge Simulator/Engine Room Simulator
G.M.D.S.S. – G.O.C. ISM / ISO Course
Radar navigation, radar plotting, use of A.R.P.A. Ro-Ro / Pass /Ferry
Medical care
Ship Security Officer/Security Awareness Vaccination against yellow fever expire:
P R E V I O U S S E RVI C E - E X P E R I E N C E AT S E A
Vessel’s Name Flag Type DWT/ ME/ BHP Rank Period Ship’s Managers and Crewing Agents
GRT from – to (include telephone number)

Date: Applicant signature: