Professional Documents
Culture Documents
Doc No:
Valid From:
Version:
Author:
Marine HR TKG - 51
28/06/2005
1
John Williams
Please complete the attached form by hand or electronically (you can type directly in the fields
provided). Please send the completed application to LNGrecruitment@teekay.com, or fax it to
+44 (141) 243 2100.
Date:
Nationality
India
Photo
Age 28 Yrs
Next of kin
Mobile number
Fax number
Email address
+91-9621111599
4usachin@gmail.com
Height 167 cm
Weight 56 kgs
U.S. Visa
Yes
Type
C1D
Valid until
16/07/2017
Other Visa
Type
Valid until
Other Visa
Type
Valid until
Professional Qualifications
Licences
Grade of
licence
Number
Date issued
Place
issued /
Revalidated
Expiry Date
National
(please state)
Yes
2MFG
IF-22182
Bahamian
Liberian
Panamanian
Doc No:
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Author:
Marine HR TKG - 51
28/06/2005
1
John Williams
Seamans book
number /
Nationality
Expiry date
Passport
nationality /
Number
Expiry date
Referees:
Name, company
and contact
telephone number
1)
2)
Place held
Date held
Date of expiry
Signature:
Doc No:
Valid From:
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Author:
Marine HR TKG - 51
28/06/2005
1
John Williams
Last
Vessel name
Containment
Type e.g.
(No.96;MKIII;
IHISPB;Moss)
Type of
vessel (Lng,
Oil, Product
etc)
Steam or
Motor
(S or M)
Company
name
Rank
Period
From To
Days / Months
nd
2 Last
rd
3 Last
th
4 Last
th
5 Last
th
6 Last
th
7 Last
th
8 Last
th
9 Last
10th Last
Doc No:
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Author:
Marine HR TKG - 51
28/06/2005
1
John Williams
th
11 Last
th
12 Last
th
13 Last
th
14 Last
th
15 Last
Other experiences (New buildings / Dry docks / Repair yards / Office secondments, etc.
Doc No:
Valid From:
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Author:
Marine HR TKG - 51
28/06/2005
1
John Williams
Date Attended
Remarks
Crisis Management
Doc No:
Valid From:
Version:
Author:
Marine HR TKG - 51
28/06/2005
1
John Williams
Welding
Crowd Management
Draughtercraft Coxswain
Helideck Assistant