Registration Form

Name: __________________________________________________

Date of Registration: _______________________________________

Permanent Address: _______________________________________

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Home Phone No: ______________ Mobile No: _________________

Other Numbers: ______________

Email Address: ___________________________________________

Personal Details:

Nationality: __________________ Passport No: _________________

VISA Details: ____________________________________________

Male / Female

Date of Birth (d/m/y): ____ / ____ / ____

Hair Colour: ___________ Weight: ___________ Height: __________

Eye Colour: ___________ Smoke? Yes / No Drink? Yes / No

Would you take a drug test if asked? Yes / No

Dive Certificates: __________________________________________

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What languages do you speak? _______________________________

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Please choose your first and second preference:

Please tick your choice of vessel position:

Please detail your Up Holding Licenses: __________________________

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Please rate your ability in these areas from 1 - 10:

Please tick which you are capable of

Please list your training, which schools you graduated from and what year?

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Please choose which cuisines you specialize in?

Please detail what licenses you hold?

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Please note how you heard about Crew Pacific

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Yes, I give Crew Pacific consent to provide my resume and personal details to other Crewing agencies for the purpose of gaining employment.

Note: Print registration form, fill out clearly, attach registration fee and resume, and post to:

Crew Pacific
15A Law Street
North Cairns
Australia 4870