APPLICATION FORM
1
Position
Position applied for:
E FITTER
Are you willing to accept any other positions?
FITTER
If YES, which positions would you consider?
YES
Readiness From
Last drawn Wages
1,000 USD
2
Personal details
Name:
Last Name(as per passport) MR MANOP
First Name(as per passport) LEKRAT
Date/place of birth:
13 OCT 1982
Nationality:
THAI
Height in Cms.
1.69
Weight in Kgs.
65 KG
Color of eyes
BLACK
Color of Hair
Boiler suit size
Shoe size
Food Habit
BLACK L 8
Permanent Address:
106/1 M.4 T.NAYANG A.PICHAI J. UTTARADIT 53120
Post code:
( No.:
( Mobile No.:
+66 94 649 3374
E-Mail ID:
MANOP1982CARE@HOTMAIL.COM
3
Education Background
Name
From Year
To Year
Highest Qualification Attained
School
College
: Polytechnic Sisaket
13 MAY 10
07MAY12
High Certificate
Technicmechanical merchant ships
Pre Sea Training
Other Qualifications
4
Identity documents
DOCUMENT
COUNTRY
NUMBER
ISSUED
PLACE
EXPIRY(DD/MM/YYYY)
Passport:
National THAI
AA2055746
13 AUG 2013
MINISTRY OF FOREING AFFAIRS
12 AUG 2018
Seaman’s book:
National THAI
H 11204
08 JUL 2014
THE MARINE DEPARTMENT
07 JUL 2019
Bahamian
Liberian
Panamanian
Other -Norway
Yellow Fever
15 OCT 13
LOT NO. COO-0275367
Date of expiry
15 OCT 23
Do you hold a US Visa ‘C1’?
Date of Issue
Date of expiry
Do you hold a US Visa ‘D’?
Date of Issue
Date of expiry
Do you hold Australian MCV
Date of Issue
Date of expiry
Have you been rejected for any visa applied for?
If YES, please state the country and reasons
APPLICATION FORM
1
Position
Position applied for:
E FITTER
Are you willing to accept any other positions?
FITTER
If YES, which positions would you consider?
YES
Readiness From
Last drawn Wages
1,000 USD
2
Personal details
Name:
Last Name(as per passport) MR MANOP
First Name(as per passport) LEKRAT
Date/place of birth:
13 OCT 1982
Nationality:
THAI
Height in Cms.
1.69
Weight in Kgs.
65 KG
Color of eyes
BLACK
Color of Hair
Boiler suit size
Shoe size
Food Habit
BLACK L 8
Permanent Address:
106/1 M.4 T.NAYANG A.PICHAI J. UTTARADIT 53120
Post code:
( No.:
( Mobile No.:
+66 94 649 3374
E-Mail ID:
MANOP1982CARE@HOTMAIL.COM
3
Education Background
Name
From Year
To Year
Highest Qualification Attained
School
College
: Polytechnic Sisaket
13 MAY 10
07MAY12
High Certificate
Technicmechanical merchant ships
Pre Sea Training
Other Qualifications
4
Identity documents
DOCUMENT
COUNTRY
NUMBER
ISSUED
PLACE
EXPIRY(DD/MM/YYYY)
Passport:
National THAI
AA2055746
13 AUG 2013
MINISTRY OF FOREING AFFAIRS
12 AUG 2018
Seaman’s book:
National THAI
H 11204
08 JUL 2014
THE MARINE DEPARTMENT
07 JUL 2019
Bahamian
Liberian
Panamanian
Other -Norway
Yellow Fever
15 OCT 13
LOT NO. COO-0275367
Date of expiry
15 OCT 23
Do you hold a US Visa ‘C1’?
Date of Issue
Date of expiry
Do you hold a US Visa ‘D’?
Date of Issue
Date of expiry
Do you hold Australian MCV
Date of Issue
Date of expiry
Have you been rejected for any visa applied for?
If YES, please state the country and reasons
ฟอร์มเลขที่ : R-Q001
แก้ไขครั้งที่ : 00
วันที่อนุมัติ : 1Jul 2013
หน้า : 1 ของ 5
ฟอร์มเลขที่ : R-Q001
แก้ไขครั้งที่ : 00
วันที่อนุมัติ : 1Jul 2013
หน้า : 1 ของ 5