ULTRAMARINE

On-line form

Please use the on-line form and forward us with all relevant information regarding your experience and skills.

ULTRAMARINE POLAND SP Z O.O.
ul. Akacjowa 19A
81-520 Gdynia
Poland

PERSONAL DATA

NAME AND SURNAME
TELEPHONE
DATE OF BIRTH	day / month / year
ADDRESS
EDUCATION
PHOTO

LANGUAGES

English
German
Other:

PERSONAL SKILLS

years of experience in shipyard work
skill	own valuation of skills (1-5) 'no record' means no experience whatsoever
blasting
blasting of tanks
painting
painting of tanks
zinc painting
water blasting
tank cleaning
general works
mechanic works
electric works
welding
metalization
forklift licence
operating of pumps
crane licence
operating of munters
scaffolding setters
pipe fitter
hull fitter
other skills: own company:

FORMER EMPLOYERS

name of employer:	period of work (day, month, year):
	from: until:
	from: until:
	from: until:

DECLARATION

"Hereby I declare that all information regarding my professional experience and my qualifications regarding shipyard work, painting and blasting is true and complete. I agree to obey all the safety and security regulations regarding the above mentioned work and remain sober during work and travel. At the same time I declare that I am full aware of the fact that the contract will be terminated immediately and I will be charged the costs of ticket to work and back home if my statement regarding my qualifications was false."

I read and accept the contance of the declaration

DATE
21-05-2012