crew form 01b application form cadets

8/16/2019 CREW FORM 01b Application Form Cadets

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CREWING MANUAL SECTION 3

Ref: Crew/Form/01b Version:01/03/2014

TITLE: APPLICATION FORM FOR CADETS

CADET APPLICATION FORM ATTACH

RECENT

PHOTOMANDATORY

Position applied o! CMA CGM "essel # $

A%aila&i&it' date$

* : For RTO, indicate the proposed esse! and, aai!a"i!it# $ate and p!anned d%ration

&re #o% app!#in' %pon persona! or pro(essiona! reco))endation +E/-O

I( +E, p!ease state .ho

%rna)e: First na)e:

Other na)es no.n as -ationa!it#:

!ace o( "irth: $ate o( irth: &'e: a!e Fe)a!e

Passport

-%)"er !ace o( iss%e $ate o( iss%e $ate o( epir# Iss%in' &%thorit#

Visas

T#pe -%)"er !ace o( iss%e $ate o( iss%e $ate o( epir#

1/$ 5&7

&%stra!ia Entr# isa

V 5&%stra!ia7

chen'en

Education Background -a%tica! choo! / o!!e'e / niersit# Fro) To 8i'hest 9%a!i(ication attained

Personal detailsF%!! address:

osta! code: o%ntr#:

E)ai!:

8o)e te! n%)"er:

o"i!e phone:

$o)estic &irport Internationa! &irport

arita! stat%s:

F%!! na)e o( -et o( in: Re!ationship

Dependents

-a)e $ate o( "irth &'e ;ender Re!ationship

CMA SHIPS Singapore

CMA S(ips ROMANIA)3t( Ale*and!+ P+s,in St!eet- CONSTANTA C.P. /00112

Tel$ 20 42)1)0556 7 20 42)1)055/ E89ail$ :n;.appli:ation<:9as(ips.:o9Pe!sonal data ope!ato! no.)/256

&ddress o( -et o( in i(di((erent (ro) a"oe

honei( di((erent (ro) a"oe






CMA SHIPS Singapore

Person to contact in case of emergency

-a)e: Re!ationship

&ddress:

hone n%)"er: o"i!e n%)"er:

National Seaman's Book

-%)"er !ace o( iss%e $ate o( iss%e $ate o( epir# Iss%in' &%thorit#

National Cadet Diploma

;rade Iss%in' &%thorit# -%)"er $ate o( iss%e $ate o( epir# !ace o( Iss%e $ate rea!idated $ate epir#

Medical Fitness Certificate

T#pe $ate o( iss%e $ate o( Epir#

Yello Fe!er Vaccination

$ate o( Iss%e $ate o( Epir#

Foreign languages ot"er t"an Englis"

Lan'%a'eLee!:

e'inner Inter)ediate &danced

Personal details

8ei'ht: <ei'ht: o!o%r o( 8air:

o!o%r o( e#es: a(et# shoes si=e: oi!er s%it si=e:

ni(or) hirt si=e: ni(or) Tro%sers si=e:

Details of ot"er Marine courses

T#pe o( arine o%rse Re(erence Re'%!ation -%)"er $ate o( iss%e $ate o( epir#

asic Trainin'

1

& , I 4 T

R & I - I - ;

1>1?T< Re'> &VI/11

asic Fire Fi'htin' 1>20T< Re' &VI/12

E!e)entar# First &id 1>13T< Re' &VI/13

1>21

T< Re' &VI/14

ro(icienc# in s%ria! cra(t @ Resc%e oats 1>23T< Re' &VI/2 par 1>3

edica! First &id 1>14T< Re' &VI/41

IO )ode!co%rse

1>1? 1>20 1>13 1>21

T< Re'> &VI/11 to &VI/14

ersona! %ria!Techni9%es

ersona! a(et# @ ocia!Responsi"i!ities 58%)anRe!ationship7






CMA SHIPS Singapore

edica! are 1>1AT< Re' &VI/42 par 2



4/6




CMA SHIPS Singapore

Employment "istory

annin' &'ent Vesse! t#pe ** F!a' osition i'n on date i'n o(( date Tota! ))/dd

#egional $raining %fficer 's Selection Criteria

Lee! o( En'!ish <ritin' : peaBin' :

VO& / re E)p!o#)ent Test res%!t :

adet detai!s, $ip!o)a and erti(icates postin' into & +es -o

&ssessed potentia! o( the adet :

$ate !ace i'nat%re

Cadet's commitment to follo CM&S(PS training monitoring program

I, %ndersi'ned CCCCCCCCCCCCCCCCC certi(ied that I receied detai!ed in(or)ation to the &8I adet Trainin' onitorin' ro'ra)

and I receied a cop# o( the &8I adet ;%ide .hich .as presented and (%!!# ep!ained>

I certi(# that I .i!! co)p!# to the adet trainin' pro'ra) %nder s%perision o( the Train' O((icers on "oard and ashore>

$ate !ace i'nat%re

Vesse! #

# or ind%str# sector i( ashore

## se a""reiation: PC D %re container, GC D ;enera! ar'o, =C D %!B arrier, LNG D TanBer, LPG D TanBer, C(e9 D he)ica!, RoRo D Ro!! on Ro!! o((

### se a""reiation: MR D edica! Reason, "S D Vesse! o!d, EOC D End o( ontract



ACORDUL PERSOANEI CARE SOLICITASERVICIUL DE RECRUTARE SI PLASARE IN DOMENIUL NAVIGANTcu privire la prelucrare si rans!iere a "aelor cu caracer personal

#$ In%or!aii prelucrae&

Su'se!naul:

Co" i"eni%icare (CNP)Pasapor*:

CMA S+ips ROMANIA,-+ Ale.an"ru Pus/in Sree0 CONSTANTA C$P$ 122334Tel& 542 #4,3,2667 ) 542 #4,3,2661 E8!ail&cn9$applicaion:c!as+ips$co! Personal "aa operaor no$,1467

,$ ;!i e.pri! <n !o" e.pres consi!a!=nul ca societatea comerciala CMA SHIPS

ROMANIA S.R.L (denumita in continuare CMA SHIPS ROMANIA) inregistrata ca operator dedate cu caracter personal nr. !"#$ sa prelucre%e in&ormatiile indicate la punctul ' de mai osinregistrate pe numele meu in eidentele proprii si sa transmita aceste date catre societati des*ipping si+ sau cre,ing- cum ar &i- dar &ara a se limita la acestea- CMA SHIPS (persoana

uridica &rance%a cu sediul in "- uai d/Arenc 011' Marseille- 2rance).

Imi e3prim- de asemenea- acordul ca CMA SHIPS ROMANIA sa solicite date cu priire la persoana mea de la institutii+societati- precum si consultarii in&ormatiilor 4nregistrate pe numelemeu 4n 5a%ele de date ale acestora- ori de cate ori este necesar- in scopul initierii si+ sau derularii

procesului de anali%are si+ sau apro5are a solicitarii mele in ederea recrutarii+ plasarii ca personal naigant.

a) date cu caracter personal a6nd &unctie de identi&icare precum (nume- prenume- data si localnasterii- cod numeric personal- domiciliul- se3- numar de tele&on &i3+ mo5il+ &a3- adresa de email-

starea ciila- numar de copii- &otogra&ia- inaltimea- greutatea- numele si adresa angaatoruluiactual si+ sau a angaatorilor anteriori- data angaarii- ocupatia- pasaport- carnet de marinar- i%e)

5) in&ormatii legate de educatia si pregatirea pro&esionala (studii- lim5i straine cunoscute precumsi gradul de cunoastere a acestora- licente- certi&icate de capacitate- cursuri IMO)

c) in&ormatii re&eritoare la actiitatea anterioara (e3perienta pe &unctie si tipuri de nae-cali&icatiele o5tinute - numele naelor- datele de im5arcare si de5arcare- datele de contact aleoperatorilor naelor respectie- nationalitatea celorlalti mem5rii de ec*ipa cu care a serit la

5ordul naelor).

d) date re&eritoare la &unctia pentru care aplica- tipul+ tipurile de nae de care este interesat- datade la care este disponi5il- salariul minim acceptat.

A! lua la cunosina %apul ca <!i po e.ercia oae "repurile preva9ue "e Legea nr$366)#22, penru proecia persoanelor cu privire la prelucrarea "aelor cu caracer

personal si li'era circulaie a acesor "ae0 pu'licaa <n Moniorul O%icial nr$612),#$,#$#22,0 <n !o" special ur!aoarele "repuri&

(i* Drepul "e acces la "ae: dreptul de a o5tine la cerere si 4n mod gratuit- pentru o solicitare pean- con&irmarea &aptului ca datele 4n legatura cu mine sunt sau nu prelucrate de catre un anumitoperator. In ceea ce priveste CMA SHIPS Romania., acest drept poate fi exercitat in urmatoareleconditii: se adreseaza o cerere catre CMA SHIPS Romania, intocmita in forma scrisa, datata si

semnata in care se va mentiona adresa de domiciliu a persoanei care isi exercita dreptul. Cereriii se va atasa o copie xerox, lizibila, dupa actul de identitate al solicitantului

(ii* Drepul "e inervenie: dreptul de a o5tine- la cerere si 4n mod gratuit- recti&icarea-actuali%area- 5locarea- stergerea sau trans&ormarea in date anonime a datelor a caror prelucrarenu este con&orma legii- 4n special a datelor incomplete sau ine3acte. In ceea ce priveste CMASHIPS Romania acest drept poate fi exercitat in urmatoarele conditii: se adreseaza o cererecatre institutia care a inscris datele la CMA SHIPS Romania intocmita in forma scrisa, datata si

semnata, in care se vor mentiona datele asupra carora se solicita interventia, motivul !ustificat si modul de interventie. Cererii i se va atasa o copie xerox, lizibila, dupa actul de identitate al solicitantului

(iii* Drepul "e opo9iie: de a ma opune 4n orice moment- din motie 4ntemeiate si legitimelegate de situatia mea particulara- ca datele care ma i%ea%a sa &aca o5iectul unei prelucrari- cue3ceptia ca%urilor in care e3ista dispo%itii legale contrare. In ceea ce priveste CMA SHIPS

R"MA#IA. acest drept poate fi exercitat in urmatoarele conditii: se adreseaza o cerere catreCMA SHIPS R"MA#IA, intocmita in forma scrisa, datata si semnata, in care se vor mentionadatele asupra carora se solicita opozitia si motivul intemeiat si le$itim le$at de situatia

particulara a persoanei. Cererii i se va atasa o copie xerox, lizibila, dupa actul de identitate al solicitantului.



AGREEMENT O> THE PERSON ?HO APPLIESSEA8GOING RECRUITMENT AND CRE?ING SERVICEIn relaion o personal "aa processing an" su'!ission

#$ Processe" in%or!aion&

I0 +e un"ersigne":

I"eni%icaion Co"e (Personal Nu!'er)Passpor*:

CMA S+ips ROMANIA,-+ Ale.an"ru Pus/in Sree0 CONSTANTA C$P$ 122334Tel& 542 #4,3,2667 ) 542 #4,3,2661 E8!ail&cn9$applicaion:c!as+ips$co! Personal "aa operaor no$,1467

,$ I e.press e.pressl@ !@ consen t*at t*e trading compan7 CMA SHIPS ROMANIA S.R.L

(*ereina&ter CMA SHIPS ROMANIA) registered as personal data operator no. !"#$ to processt*e in&ormation indicated in paragrap* ' 5elo, registered in m7 name in its o,n records andsu5mit t*ese data to ot*er s*ipping and+ or cre,ing companies- suc* as- 5ut not limited to- CMASHIPS (2renc* legal person ,it* t*e registered o&&ice in "- uai d/Arenc 011' Marseille-2rance).

I also e3press m7 consent &or CMA SHIPS ROMANIA to in8uire data a5out me &rominstitutions+companies- as ,ell as to consult t*e in&ormation recorded on m7 name in t*eirdata5ases- ,*eneer necessar7- on purpose to initiate and+ or deelop t*e reie, and+ orapproal process &or m7 application &or t*e recruitment+ cre,ing as sea9going personnel.

a) personal data ,it* identi&ication &unction suc* as (surname- name- date and place o& 5irt*- personal num5er- domicile- se3- &i3ed+ mo5ile+ &a3 num5er- email address- ciil status- num5er o&

c*ildren- p*otograp*- *eig*t- ,eig*t- name and address o& present emplo7er and+ or preiousemplo7ers- date o& emplo7ment- occupation- passport- seaman 5oo- isas)

5) in&ormation related to pro&essional education and training (studies- &oreign languages no,n-as ,ell as t*eir degree o& no,ledge- licenses- a5ilit7 certi&icates- IMO courses)

c) in&ormation related to preious actiit7 (e3perience on positions and t7pes o& s*ips- ratingso5tained- names o& s*ips- em5aring and de5aring dates- contact data o& t*ose s*ip operators-nationalit7 o& t*e ot*er cre, mem5ers ,it* ,*om *e sered on 5oard t*e s*ips).

d) data related to t*e position &or ,*ic* *e applies- t7pe+ t7pes o& s*ips *e is interested in- date&rom ,*ic* *e is aaila5le- minimum ,ages accepted.

I oo/ noe o% +e %ac +a I !a@ e.ercise all +e rig+s provi"e" '@ La no$ 366)#22, on

personsB proecion in relaion o personal "aa processing an" %ree circulaion o% +ese"aa0 pu'lis+e" in +e O%%icial Ga9ee no$ 612),#$,#$#22,0 especiall@ +e %olloing rig+s&

(i* Rig+ o% access o "aa: t*e rig*t to o5tain upon re8uest and &ree o& c*arge- &or oneapplication per 7ear- t*e con&irmation o& t*e &act t*at t*e data related to me are processed or not

57 a speci&ic operator. In relation to CMA SHIPS Romania., t%is ri$%t ma& be exercised undert%e follo'in$ conditions: an application is submitted to CMA SHIPS Romania, dra'n up in'ritten form, dated and si$ned in '%ic% t%e domicile of t%e person '%o exercises %is ri$%t s%allbe mentioned. A (erox, le$ible cop& of t%e applicant)s identit& document s%all be attac%ed to t%eapplication

(ii* Inervenion rig+: rig*t to o5tain- upon re8uest and &ree o& c*arge- t*e recti&ication-updating- 5locing- deletion or trans&ormation in anon7mous data o& t*e data ,*ose processingdoes not compl7 ,it* t*e la,- especiall7 incomplete or inaccurate data. In relation to CMA

SHIPS Romania, t%is ri$%t ma& be exercised under t%e follo'in$ conditions: an application is submitted to t%e institution '%ic% recorded t%e data at CMA SHIPS Romania dra'n up in'ritten form, dated and si$ned, in '%ic% t%e data on '%ic% t%e intervention is re*uired, t%e

!ustified reason and t%e intervention manner s%all be mentioned. A (erox, le$ible cop& of t%eapplicant)s identit& document s%all be attac%ed to t%e application

(iii* Opposiion rig+: to oppose in an7 moment- &or an7 usti&ied and legitimate reason relatedto m7 particular situation- to t*e processing o& t*e data t*at regard me- e3cept &or t*e cases in,*ic* t*ere are contrar7 legal proisions. In relation to CMA SHIPS R"MA#IA. t%is ri$%t ma&be exercised under t%e follo'in$ conditions: an application is submitted to CMA SHIPS

R"MA#IA, dra'n up in 'ritten form, dated and si$ned, in '%ic% t%e data on '%ic% t%eopposition and t%e !ustified and le$itimate reason related to t%e person)s particular situation

s%all be mentioned. A (erox, le$ible cop& of t%e applicant)s identit& document s%all be attac%edto t%e application.

crew form 01b application form cadets

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