First Name Address: Phone 1: Phone: E-mail Nationality Passport. Birth Date Height Weight Hair Color Eye Color Gender Visa Type Visa Exp Date Not on Fl Middle: City: Perms: Do You Smoke?: Will you submit to drug test?: Do you require daily Medication? Have you ever been convicted? Last Name State: Date Last Checked4n Current Location Wackenhut Background Check Completed: No CrewInsight Character Analysis Completed:No , . Preferences and Qualifications "dear Position: Either back on a remote, off grid island, or aboard a vessel as Engineer/male 1st Position: 2nd Position: Private/Charter: Power/Sail Temp/Perm Minimum Salary: Per 1st License: 2nd License: DiveQualification: Engineer Estate Manager Either Either Either 55000.00 Month None None Rescue Marital Status: Team/SolonahllTeam Team mate: Teammate 1st Position Teammate 2nd Position Chefs, from what Culinary School did you graduate? Year:0 Please mark those cuisines in which you specialize: sob Spanish No French No Dutch No German No Italian No Engineer's self rating 1.10 Refrigeration: 0 Hydraulics:0 Zip: Country USA 9/6/2013 8:54:00 AM II Yes Please Explain If Yes Please Explain STCW Certified? No Dive Guide Yes Fishing Guide No Electrician Yes Carpenter Yos Massage Therapist No Nurse/Paramedic No Nanny Hehcopter Pilot Airplane Pilot Please mark those with which you are proficient: Vegetarian No Diabetic: No Pritikin: No Asian: No Northern Yes Caterpillar: Yes Deutz: No Cummins: Yes MTU: Yes Lights: French Cuisine No Kosher: No Italian: No LowFat: No DetroitDDEC: No No No Electrical:9 1069 SE 17 Shealy. Fort Lauderdale, FL 33316 30 Rue Lacan, GaIone Du Port. Antibes. 06600 France E-mail: infotecrewunlimited com Yes KaMeWa: Yes Paxman: No Mercedes: No Mann: No Tel •1 (954)462 4624 Tel (33)04 92 36 OS 58 Internet Address: www.crewunlimited.com EFTA_R1_00425622 EFTA01955448