SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6

C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18

RECORD Issue No: 4

Part A. APPLICATION FORM

PERSONAL DATA
Applied for the position of: PHOTO
Surname: Forename:
Father’s name: Mother’s name:
Date of birth: Place of birth:
Marital status: Single Married Nationality:
Home address:
Religion:
Tel.: Tel.: e-mail:
Next of kin:
Surname: Forename:
Home address : Tel:
Defendants (number): Sons: Daughters:
Clothes size Shoes Height Weight
DOCUMENTS NUMBER ISSUING AUTHORITY Date Issued Expiry Date

Passport

Seaman’s book

National License/Diploma

S T C W Endorsement/ COC

Flag Endorsement

Medical Fitness Certificate

Yellow Fever Vaccination

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

QUALIFICATIONS (ref. to SMSM Ch.6 Table 3)

Table No. 3: Certificates and other documentation requirements

DECK ENGINE CATERING
MANAGEMENT OPERATIONAL SUPPORT MANAGEMENT OPERATIONAL SUPPORT
EL/
MST C/O 2/O 3/O BSN A/B O/S D/C P/M C/E 2/E 3/E 4/E FTR OLR E/C COOK1 M/M
EL
FLAG AND NATIONAL CERTIFICATES / DOCUMENTS / ENDORSMENTS
Seaman’s book X X X X X X X X X X X X X X X X X X X
Drug and Alcohol record X X X X X X X X X X X X X X X X X X X
Medical examination record X X X X X X X X X X X X X X X X X X X
Yellow fever / Vaccination
X X X X X X X X X X X X X X X X X X X
book (as applicable)
Passport X X X X X X X X X X X X X X X X X X X
Visa (as applicable) X X X X X X X X X X X X X X X X X X X
National licence (C.O.C.) X X X X Opt. X X X X X X X X X
Flag Endorsement X X X X X X X X
NAVIGATION AND ENGINEERING WATCH
Navig. watchkeeping A-II/1 X X
Navig. watchkeeping A-II/2 X X
Navig. Rating watchkeeping
X
A-II/4
Able seafarer Deck A-II/5 X X
E/R watchkeeping A-III/1 Opt X X
E/R watchkeeping A-III/2 X X
E/R Rating watchkeeping A-
X
III/4
Able seafarer Engine A-III/5 X
GMDSS operators A-IV/2 X X X X
ECDIS (generic)2 X X X X
ECDIS (type specific)2 X X X X
EMERGENCY, SECURITY, OCCUPATIONAL SAFETY, MEDICAL CARE AND SURVIVAL FUNCTIONS
Basic training A-VI/1-1 to 1-4 X X X X X X X X X X X X X X X X X X X
Basic Training for Oil and
X X X X X X X Opt. X X X X X X Opt. X Opt. Opt. Opt.
Chemical Tankers A-V1-1-1
Advance Training for Oil
X X X X X X X X
Tankers A-V/1-1-2
Advance Training for
X X X X X X X X
Chemical Tankers A-V/1-1-3
Proficiency in survival craft
and rescue boats, other than X X X X X X X X
fast rescue boats A-VI/2-1
Advanced fire fight A-VI/3-1 X X X X X X X X
Medical First Aid A-VI/4-13* X3 X3 X3 X3 X3 X3 X3 X3
Medical care A-VI/4-23* X3 X3 X3 X3 X3 X3 X3 X3
Ship Security Officer A-VI/5 X Opt Opt Opt Opt Opt Opt Opt
Security Awareness for
Seafarers without
X X X X X X X X X X X
Designated Security Duties
A-VI/6-1
Security Awareness for
Seafarers with Designated X X X D D D D X X D X X D D D D
Security Duties A-VI/6-2
ADDITIONAL (NON-STATUTORY) TRAINING
Safety Officer 4* X4 X4 X4 X4 Opt
BRM / BTM6, 8 X X X X
Engine Resource
X X X X
Management*
Risk assessment* X Opt Opt Opt X Opt Opt Opt

Incident investigation* X Opt Opt Opt X Opt Opt Opt

Ship handling 5 X
Train the trainer Opt Opt Opt

Media Response X Opt

Maritime English Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt
Hazardous Material Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt Opt
(HAZMAT)

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

Table No. 3: Certificates and other documentation requirements

DECK ENGINE CATERING
MANAGEMENT OPERATIONAL SUPPORT MANAGEMENT OPERATIONAL SUPPORT
EL/
MST C/O 2/O 3/O BSN A/B O/S D/C P/M C/E 2/E 3/E 4/E FTR OLR E/C COOK1 M/M
EL
Cargo handling(simulator) 5*
X X Opt.7 Opt.7

1
Cooks shall have completed a training course approved by the Flag State covering practical cookery, food and personal hygiene, food storage, stock control, and environmental protection and catering health and safety.
2
If crew is to board vessel equipped with ECDIS.
3
At least two of the said Officers must be holders. Required for those designated to provide medical first aid and /or medical care aboard ship accordingly.
4
At least one of deck Officers must be holder.
5 A Master with less than 3 Years sea service in rank, must have attended a ship handling course (In the event that the Master has in excess of 3 years’ experience, the Certificate is not needed). Master’s should also
attend this training in case of assignment to a different type of vessel. Chief Officers to be promoted to Master shall attend this course, prior taking over their new duties.
6
Refresher every 3 Years
* Refresher every 5 Years
7
Required for Junior Officer with experience more than one year as Officer.
8
Training team composition should reflect the nationalities of the Bridge Teams in fleet to increase awareness of cultural diversity, communication style and hierarchy bias among the team.
D If designated to perform security duties including anti-piracy and anti-armed robbery related activities.

CERTIFICATES YES NO Date Issued Expiry Date

Certificate of competence / licence
Navigational watchkeeping A-II
Engine Room watchkeeping A-III
ECDIS (generic)
ECDIS (type specific) – TRANSAS NAVISAILOR 4000
ECDIS (type specific) – IME 6024
GMDSS radio operators A-IV/2
Basic training A-VI/1-1 to 1-4
Basic training for Oil and Chemical Tankers A-V/1-1-1
Advance Training for Oil Tankers A-V/1-1-2
Advance Training for Chemical Tankers A-V/1-1-3
Proficiency in surv. craft & RB other than FRB A-VI/2-1
Advanced fire fighting A-VI/3-1
Medical First Aid A-VI/4-1
Medical care A-VI/4-1,2
Ship Security Officer A-VI/5
Security Awareness for Seafarers without Designated Security
Duties A-VI/6-1
Security Awareness for Seafarers with Designated Security
Duties A-VI/6-2
Safety Officer
Bridge Resource and Team Management (BRM / BTM)
Engine Resource Management (ERM)
Risk Assessment / Incident Investigation
Hazardous Material (HAZMAT)
Cargo handling & Cargo care
Ship handling
Train the trainer
Media Response
Maritime English*
*All Officers in direct control of navigation, cargo and/or bunker oil handling operations must have conversational proficiency in English

OTHER CERTIFICATES YES NO Date Issued Expiry Date

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

Training needs If NO list the certificates the applicant does not hold in the following section:

Native language:
English: Good Basic
Other languages:

PREVIOUS SEA SERVICE

SERVICE TIME REASON OF
SHIP’S NAME TYPE ENGINE DWT / BHP OWNER RANK
DATE ON DATE OFF SIGN-OFF

APPLICANT (NAME): SIGNATURE DATE

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

CREW MANAGER APPLICATION REVIEW (application’s validity to be reviewed prior each employment)
NAME / SIGNATURE DATE RE-ENGAGEMENT PROSPECTS (vessel, date, port)

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

Part B. INTERVIEW FORM

(ONLY for the accepted applicants)
Interview to be carried out by Crew Manager – Department Managers or their deputies and/or Manning Agent..
Name: Rank: Interview Date:
Carried Out AT HEAD OFFICE VIA SKYPE AT MANNING AGENTS OFFICE
B.1. General (All Crew)
Appearance/ Personality:      
Previous companies employed at.      
Type of vessels.      
English language (interview conducted in          
English language).
Personal Survival Techniques / Fire Prevention and Fire Fighting (APPLICABLE FOR RATINGS)
     
Elementary First Aid, Personal Safety and Social Relationships (APPLICABLE FOR RATINGS)
     
Which are your views on D& A policy?      
Why did you have short contract duration with previous company (where applicable)?
     
What does the term DPA/CSO mean and which are his responsibilities?
     
Which are your views on Safety Committee meetings and how frequently should they be conducted?
     
Have you experienced any accidents? What lessons have you learned?
     
Have you worked with multinational workforce? What nationalities & How was your cooperation
     
How would you ensure teamwork on board?      
Do you believe that you are should make suggestions for improvement of the Company’s operations / performance?
     
Which aspects of work do you consider harder/more stressful?      
Have you any definite plans for your career?      
Is there any specific religious origins / cultural values that we should      
know about?
Would you expect your wife / family to travel with you?      
Have you experienced any medical operation / serious illness in the          
last 12 months?
Is there any possibility to undergo any medical operation in the next          
12 months?
When would you be available?      
Contract period.       Salaries Benefits      

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

B.2. For Masters & All Deck Officers

1. MARINE / VETTING M CO 2O 3O YES COMMENTS

1. Bridge Standing Orders, Bridge Watch, BW Conditions.          

2. COLREGS          
3. Passage Plan & Deviation from Passage Plan          
4. Gross UKC – Net UKC – Static draft– Dynamic draft.          
5. Bridge Checks when underway / arrival / departure          
6. ECDIS / Publications / Corrections          
7. Mooring Operations & Mooring Maintenance          
8. Mooring Plans – Mooring wires – Mooring Ropes          
9. Mooring Winches & Testing of Winch Brakes        
10. Use and Testing of Lifting Appliances        
11. Anchoring        
12. Pilot Transfer          
13. Vetting Inspections – VIQ – CDI / Oil Majors          
14. Inspections (Flag - P&I - Port State Control)          
15. Safety Work Permits (hot work, enclosed space etc.)          
16. Safety in Cargo Operation – Cargo planning          
17. Previous experience with CPPs / Chemicals        

18. Cargo handling with pumps (Deepwell or Screw)          

19. Tank Cleaning / Change of Cargoes        
20. Ballasting / Deballasting & BWM        
21. Ship to Ship transfer        
22. LSA & FFE Inspection          
2. HSQE M CO 2O 3O YES COMMENTS
23. Risk Assessment & Incident Investigation        
24. Emergency Procedures / SMPEP / VRP / VGP          
25. Safety Meetings / Drills / NMs / NCRs
3. OPERATIONS M CO 2O 3O YES COMMENTS
26. Trading Areas          
27. Relationship with charterers / TC / Spot Voyages       
28. Leadership / Management skills        
29. ISPS / HRAs          

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

B.3 For Chief Engineers & All Engine Officers

COMMENTS
1. TECHNICAL CE 2E 3E/4E YES

1. Experience on specific Engines         

2. Problems that might exist on specific Engines and how         
they are dealt with.
3. Experience on specific Auxiliary Machinery Systems (Aux.         
Engines, Boilers, IGG).
4. Dry-docking experience       
5. Experience on cargo systems (Deepwell or Screw)         
6. Experience in use of e-PMS. What kind?        
7. Luboil / F.Oil Analysis
 Frequency of sampling
 Points and way of sampling         
 Trouble –shooting and reports
 Treatment practices
8. Fuel Oil Purification practices         
9. Oil Record Book entries Part I       
10. Oil Water Separator         
11. CO2, SOX, NOX emissions / MRV/ IMO DCS       
12. Fuel Change-over procedures       
13. Vessel’s Implementation Plan for the consistent
implementation of 0.50% Sulphur limit under MARPOL       
ANNEX VI
2. HSQE CE 2E 3E/4E YES COMMENTS
14. Risk Assessment & Incident Investigation         
15. Emergency Procedures / SMPEP / VRP / VGP         
16. Safety Meetings / Drills / NMs / NCRs         
3. MARINE / VETTING CE 2E 3E/4E YES COMMENTS
17. Steering Gear (Main & Emergency)         
18. Vetting Inspections – VIQ - CDI         
19. Inspections (Flag - P&I - Port State Control)         
4. OPERATIONS CE 2E 3E/4E YES COMMENTS
20. Trading Areas         
21. ISPS / HRAs         
22. Leadership / Management skills        

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

INTERVIEWER 1 NAME/SIGNATURE DATE

INTERVIEWER 2 NAME/SIGNATURE
DATE
(if applicable)

REFERENCES/INFORMATION, ETC. FROM PREVIOUS EMPLOYERS (to be completed by Crew Manager/Manning agent)

CERTIFICATES’ AUTHENTICITY CHECK Completed by the Crew Manager, when recruitment is conducted directly by the Company.
Completed by the Manning Agent, when the recruitment is conducted by the Manning Agency and verified by the Crew Officer.
Authenticity check conducted for certificates:
CONDUCTED BY MANNING AGENT (Name/Position)
DATE RESULTS Satisfactory Unsatisfactory
VERIFIED BY CREW DEPARTMENT (Name/position)
DATE RESULTS Satisfactory Unsatisfactory

BACKROUND SECURITY DOCUMENT PROVIDED BY THE SEAFARER

DATE:

CREW MANAGER NAME/SIGNATURE APPROVED /

ACCEPTED YES NO
COMMENTS

DATE

OFFICERS ARE TO BE INTERVIEWED ON SPECIFIC TOPICS AS DESCRIBED IN SMSM CH.6 APPENDIX I. INTERVIEWERS TO
SIGN BELOW AS APPLICABLE:

COMPANY DEPARTMENTS
DPA/EMR
NAME/SIGNATURE ACCEPTED YES NO
COMMENTS

DATE

TECHNICAL NAME/POSITION/SIGNATURE ACCEPTED YES NO

COMMENTS

DATE

MARINE NAME/POSITION/SIGNATURE ACCEPTED YES NO

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 SAFETY MANAGEMENT SYSTEM MANUAL Chapter 6
C 026 SEAGOING PERSONNEL APPLICATION AND INTERVIEW Issue Date: 01/07/18
RECORD Issue No: 4

COMMENTS

DATE

OPERATIONS NAME/POSITION/SIGNATURE ACCEPTED YES NO

COMMENTS

DATE

GENERAL MANAGER SIGNATURE ACCEPTED/

APPROVED YES NO
COMMENTS

DATE

Note: 1) Any comments shall be recorded in the relevant fields 2) Final approval as per Table 1 of SMSM Ch.6

MEDICAL EXAMINATIONS TO BE CONDUCTED PRIOR TO SEAFARER’S ENGAGEMENT

MEDICAL EXAMINATIONS AND D&A TEST COMPLETED SATISFACTORY? YES NO

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