First Name Address: Phone 1: Phone: E-mail Nationality Passports Birth Date Height Weight Hair Color Eye Color Gender Visa Type Visa Exp Date Pete Middle: City: Perms: Do You Smoke?: Will you submit to drug test?: Do you require daily Medication? Have you ever been convicted? Last Name: _OCC—bc State: Zip: Country USA Date Last Checked -1n 1/23/2013 3:26:00 PM Current Location SE USA (Florida) • Keys Wackenhut Background Check Completed: No Crewlnsight Character Analysis Completed:No If Yes Please Explain If Yes Please Explain "Ideal" Position: Captain:Mate 80 200' 10 years experience as a dive boat captain in Florida Koys and a certified PDAI Assistant Instructor 1st Position: Captain Marital Status: 2nd Position: Bosun Team/Solo/WillTeam Private/Charter: Either Team mate: Power/Sail Either Temp/Perm Either Minimum Salary: 545000.00 Per Year 1st License: USCG 1007 2nd License: None DiveQualification: NONE Chefs, from what Culinary School did you graduate? Year:O Please mark those cuisines in which you specialize: Teammate 1st Position Teammate 2nd Position Divorced solo Spanish No French No Dutch No Nanny German No Helicopter Pilot Italian No Airplane Pilot Yes Engineer's nitrating 1.10 Refrigeration: 0 Hydraulics:0 Please mark those with which you are proficient: Vegetarian No Diabetic: No Pritikin: No Asian: No Northern Lights: Yes Caterpillar: Yes Deutz: No Cummins: Yes MTU: No French Cuisine No Kosher: No Italian: Yes LowFat: No DetroitYes KalAeWa: No Paxman: No Mercedes: No Mann: No DIDEC: 1069 SE 17 Snooty. Fort Lauderdale. FL 33316 30 Rue Lacan. Galen* Du Port. Antibes, 06600 France E-Mail. infogorcwunlimitcd cam STCW Certified? No Dive Guide Yos Fishing Guide No Electrician No Carpenter No Massage Therapist No Nurse/Paramedic No No No Electrical:? Tel +1 (954)482 4824 Tel (33) 04 92 38 05 58 Internet Address: wwwcrewunlimitodcom EFTA_R1_00348721 EFTA01911825