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Crew Data Form NEW

This crew data form provides personal and employment information for Arif Setyawan. It lists his hire date of August 20, 2019 and position as Assistant Waiter. It includes his address, phone number, email, passport details, languages spoken, emergency contact and dependent information. The form captures key biographical data to facilitate Arif's employment onboard.

Uploaded by

Asrilia Lia
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
561 views2 pages

Crew Data Form NEW

This crew data form provides personal and employment information for Arif Setyawan. It lists his hire date of August 20, 2019 and position as Assistant Waiter. It includes his address, phone number, email, passport details, languages spoken, emergency contact and dependent information. The form captures key biographical data to facilitate Arif's employment onboard.

Uploaded by

Asrilia Lia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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FP1802 Crew Data Form

Hire Date August 20 2019 MAPS ID


(month) (day) (year)
NAME Setyawan Arif Dept Food and Beverage
(last) (first) Position Assistant Waiter
Onboard/Ship
Address Barepan 7 Moyudan
RT:005, RW:016 Home Airport Yogyakarta – Indonesia: JOG

City Sleman Postal Code 55563 Marital Status X


Country Indonesia Single Married Divorced Widowed Separated

Phone # +628122775652 Sex X


(country code), (city code), # Male Female
Email arif81lanang@gmail.co Personal Attributes Black Brown 168 cm 62 kg
(hair) (eyes) (height) (weight)
SS# (US Only) Date of Birth April 20 1981
(month) (day) (year)
ARC # Birthplace Sleman

Citizenship / Country Indonesia

Passport # C 3860532 Passport Issue Date July 10 2019

(month) (day) (year)

Passport Country / City of Issue Indonesia/ Yogyakarta Passport Expiry Date July 10 2024

(month) (day) (year)

Second Passport # 2nd Passport Issue Date

(month) (day) (year)

2nd Passport Country / City of Issue 2nd Passport Expiry Date

(month) (day) (year)

Seaman’s Book # B 068826 Seaman’s Book Issue Date Mei 27 2013

(month) (day) (year)

Seaman’s Book Country of Issue Indonesia Seaman’s Book Expiry Date Mei 26 2020

(month) (day) (year)

Nove
C1D Visa # K 3486929 C1D Visa Expiry Date 19 2019
mber
(month) (day) (year)

Date of last Physical Exam

(month) (day) (year)

Languages (Other than English) - Indonesia

Emergency Contact Dependent Information

Name Eni Kurniawati Name Date of Birth


Relationship Wife

Address Barepan 7 Moyudan

RT:005, RW:016

City/State Yogyakarta

Country Indonesia

Phone #

Mobile # +6281227986586

Sign off Date


(month) (day) (year) Signature

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