Seafarers Application Form

Guidance:

  1. * Kindly fill up the form as given below
  2. * Mandatory entries are the Passport, CDC and INDOS Number that are important for generating your employee id.
  3. * Unless you don't submit this page you cannot proceed to the next.
  4. * After entering all details below click on "Save and Continue" (at the bottom of the page) to go to the next tab.
  5. * Fill in the Sea Going Experience as is with Your Employer name and contract Sign-on/off dates.
  6. * In the Certificates & Qualifications Section you may zip all certificates and upload them in the space given there.
  7. * For successful submission of this form complete all tabs and click "submit" in the references tab.
  8. ** While filling up the form kindly refrain from Refreshing the page and/or using the Backspace / return button as this will affect the data entered by you.
**Note: Darya does direct recruitment. We do not have any agents or brokers acting on behalf of the company. Be aware of fraudulent job offers misusing our name and report immediately to us.
Personal DetailsSea Going ExperienceCertificates & QualificationsReferences
Position Applied For:
No Image
Are you willing to Accept a lower position?
Date available if selected?            
First Name: Mid Name:
 
Surname: Gender:
Date of Birth:   Place: Age:
Marital Status: Nationality:  
Nearest Airport:

Address (1) (Present):
Telephone:
Mobile:
E-mail:
Fax:
City: Pin Code:
Address (2) (Permanent):
Telephone:
Mobile:
E-mail:  
Fax:
City: Pin Code:

Family Details:
Next of Kin: Relation:
Address: Telephone:
Mobile:
E-mail:

Banking Details
Name Of Bank: A/C No.:
Type Of Account (Savings, Current): Bank Address:
SWIFT Code: IFSC Code:
Beneficiary Name: PAN No.:
Travel & CDC Documents
DocumentsCertificate NumberIssued DateExpiry DatePlace of issueRemark


Medical History
Have you ever signed off any ship due to medical reasons ?
 
Have you undergone any surgery in the past ?
 
Have you consulted a doctor during the last 12 months for any illness or accident ?
 
Have you ever been tested positive for any drug and alcohol test ?
 
Conducted on date: Conducted by:
Medical Report: Upload file:
Remarks:

(Please mention Yes, No or N/A if the form is being filled manually)

Height: In cms Weight: In kgs BMI: Shoe Size: Boiler Suit Size: Blood Group: