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SEAFARER'S APPLICATION FORM

PERSONAL INFORMATION ( DATE PERSONALE)

Family Name (Nume)

ROSCA

First Name(s) (Prenume)

Vasilica-Dorel

Birth Date (Data Nasterii)

31.12.1988

Birth Place (Locul nasterii)

Constanta

Nationality (Nationalitate)

Romanian

Weight (kg) (Greutate in Kg)

89...