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Seafarer Registration Form
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Personal Details
Name
Rank
Select Rank
2nd Cook
\
2nd Engineer
\
2nd Officer
\
3rd Engineer
\
3rd Officer
\
4th Engineer
\
5th Engineer
\
AB
\
Administrative Officer
\
Asst. Electrical Officer
\
Bar Tender
\
Bosun
\
Cabin Attendant
\
Chief Cook
\
Chief Engineer
\
Chief Officer
\
Crane Operator
\
Deck Cadet
\
Deck Fitter
\
Doctor
\
Electrical Engineer
\
Electrical Officer
\
Electro Technical Officer
\
Engine Fitter
\
Gas Engineer
\
General Steward
\
GP
\
Hotel Manager
\
Junior Engineer
\
Junior Officer
\
Laundry Men
\
Master
\
Motorman
\
Musician
\
Oiler
\
OS
\
Others
\
Pumpman
\
Radio Officer
\
Reefer Engineer
\
Reefer Mechanic
\
Security Guard
\
Store Keeper
\
Trainee OS
\
Trainee Wiper
\
Wiper
\
Date of Birth
Gender
Please Select
Male
Female
Marital Status
Select
Single
Married
Divorced
Nationality
Contact Details
Email ID
Phone Number
Mobile Number
Permanent Address
Permanent City
Permanent State
Permanent Zip Code
Permanent Country
Please Select
Afghanistan
Albania
Algeria
American Samoa (USA)
Andorra
Angola
Anguilla (UK)
Antigua and Barbuda
Argentina
Armenia
Aruba (Netherlands)
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda (UK)
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Indian Ocean Territory (UK)
British Virgin Islands (UK)
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cayman Islands (UK)
Central African Republic
Chad
Chile
China
Christmas Island (Australia)
Cocos (Keeling) Islands (Australia)
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands (New Zealand)
Costa Rica
Croatia
Cuba
Curacao (Netherlands)
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (UK)
Faroe Islands (Denmark)
Fiji
Finland
France
French Polynesia (France)
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar (UK)
Greece
Greenland (Denmark)
Grenada
Guam (USA)
Guatemala
Guernsey (UK)
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong (China)
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man (UK)
Israel
Italy
Jamaica
Japan
Jersey (UK)
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau (China)
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mayotte (France)
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat (UK)
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia (France)
New Zealand
Nicaragua
Niger
Nigeria
Niue (New Zealand)
North Korea
Northern Mariana Islands (USA)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands (UK)
Poland
Portugal
Puerto Rico (USA)
Qatar
Reunion (France)
Romania
Russia
Rwanda
Saint Barthelemy (France)
Saint Helena (UK)
Saint Kitts and Nevis
Saint Lucia
Saint Martin (France)
Saint Pierre and Miquelon (France)
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Netherlands)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen (Norway)
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau (New Zealand)
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands (UK)
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
US Virgin Islands (USA)
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Wallis and Futuna (France)
Yemen
Zambia
Zimbabwe
Communication Address Same As Permanent Country
Communication Address
Communication City
Communication State
Communication Zip Code
Communication Country
Please Select
Afghanistan
Albania
Algeria
American Samoa (USA)
Andorra
Angola
Anguilla (UK)
Antigua and Barbuda
Argentina
Armenia
Aruba (Netherlands)
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda (UK)
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Indian Ocean Territory (UK)
British Virgin Islands (UK)
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cayman Islands (UK)
Central African Republic
Chad
Chile
China
Christmas Island (Australia)
Cocos (Keeling) Islands (Australia)
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands (New Zealand)
Costa Rica
Croatia
Cuba
Curacao (Netherlands)
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (UK)
Faroe Islands (Denmark)
Fiji
Finland
France
French Polynesia (France)
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar (UK)
Greece
Greenland (Denmark)
Grenada
Guam (USA)
Guatemala
Guernsey (UK)
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong (China)
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man (UK)
Israel
Italy
Jamaica
Japan
Jersey (UK)
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau (China)
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mayotte (France)
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat (UK)
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia (France)
New Zealand
Nicaragua
Niger
Nigeria
Niue (New Zealand)
North Korea
Northern Mariana Islands (USA)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands (UK)
Poland
Portugal
Puerto Rico (USA)
Qatar
Reunion (France)
Romania
Russia
Rwanda
Saint Barthelemy (France)
Saint Helena (UK)
Saint Kitts and Nevis
Saint Lucia
Saint Martin (France)
Saint Pierre and Miquelon (France)
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Netherlands)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen (Norway)
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau (New Zealand)
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands (UK)
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
US Virgin Islands (USA)
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Wallis and Futuna (France)
Yemen
Zambia
Zimbabwe
Visa / Passport Details
Passport No.
Passport Expiry Date
Place of Issue
Visa
Select Country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia
Botswana
Bouvet Island
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Caicos Islands
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo Brazzaville
Congo
Cook Islands
Costa Rica
Cote Divoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
England
Equatorial Guinea
Eritrea
Estonia
Ethiopia
European Union
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea-Bissau
Guinea
Guyana
Haiti
Heard Island
Honduras
Hong Kong
Hungary
Iceland
India
Indian Ocean Territory
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands Antilles
Netherlands
New Caledonia
New Guinea
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre
Saint Vincent
Samoa
San Marino
Sandwich Islands
Sao Tome
Saudi Arabia
Senegal
Serbia
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timorleste
Togo
Tokelau
Tonga
Trinidad
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States
Uruguay
Us Minor Islands
Us Virgin Islands
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
NONE
Visa Type
Visa Expiry Date
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