Case File
efta-01736085DOJ Data Set 10OtherEFTA01736085
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01736085
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
CREW APPLICATION FORM
6
Crew le,atIon41
Specializing In the Placement of Professional, Qualified Crew
for the Luxury Mega Yacht Industry
Be a Part of the Team, the "Best of the Best"
Position:
In Yachting Since:
Today's Date:
Start Date:
Name:
Salary:
Negotiable: VD ND
Current Local Contact Address: Street/Crew House
City:
State:
Zip:
Cell Phone:
WhatsApp Phone Number:
Skype:
E-mail:
Emergency Contact Information: Name/Relationship:
Street:
City & State:
E-mail:
Cell Phone:
Phone:
Personal Data
Nationality:
US Green Card: Y K
N
Drivers License #:
Passport #:
Expiry Date:
US Travel Visa:
Expiry Date:
Height:
Weight:
Date of Birth:
ELITE
Uniform Size (US): Shirts:
Pants:
Shoes:
Will
Place
Do you Smoke?
Y O
N o Occasionally O
Daily O
Your
Do you Drink?
Y O
N O
Occasionally O Daily O
Photo
Here
Any Medical Conditions?
YO
NO
If yes, Explain:
Dietary Requirements:
Do you have tattoos that will be visible in uniform? YO NO
If yes, explain location & size
Languages Spoken:
Computer Literacy: Beginner O
Intermediated Advanced O
112 Rose Drive
Fort Lauderdale, Florida, 33316 USA
Drug Test: Will Take: YE NE Date Taken:
Ever Convicted/Arrested: Y K NE Reason:
One Ocean, Marina Port Vell
Carrer Escar, 26, Barcelona, Spain
Agree to Background Check: YE NE Date Completed:
08039
Hobbies:
Last book you read:
FLL Ph:
Dive Certified: YE NE Level:
BCN Ph:
STCW-95 Certified: YE NE Highest License:
Valid ENG-1 Medical: YO N O
Expiry Date:
Additional Licenses:
Website: www.elitecrewintl.com
In accordance with MLC 2006, I
verify that the above information is correct.
EFTA_R1_00020253
EFTA01736085
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