On-board Familiarization Form
SHIP :
Joining Staff: Name: Rank:
ITEMS TO BE COMPLETED BEFORE SAILING
* Delete as necessary
1. Check EMERGENCY SIGNALS YES NO
2. Check LIFEBOAT STATION location lifeboat No:
3. Check your emergency party and abandon ship duties YES NO
3a. Have you carried out this duty before? YES NO
If No, asks Officer in charge to explain in detail.
4. Check location of EMERGENCY MUSTER STATION YES NO
5. Check escape routes from your cabin and work place to Lifeboat
Station and Emergency Muster Station YES NO
6. Have you located the 2 fire extinguishers nearest to your cabin? YES NO
6a. Have you used this type of extinguishers before? YES NO
If NO asks Officer in charge to explain the correct operating instructions
7. Are you made aware of method of raising a FIRE ALARM? YES NO
8. Have you located the nearest INTERNAL TELEPHONE AND
FIRE ALARM BUTTON (if applicable)? YES NO
9. Have you located, checked and donned your LIFEJACKET/EEBD/ YES NO
Immersion suit?
10. All Officers and Crew: Workplace Familiarization. (You must be familiar YES NO
with your workplace before taking full responsibility for the same).
11. Have you been instructed about safe operation of the ship’s watertight
doors, fire screen doors, weathertight doors?
(if applicable to your vessel and your basic duties) YES NO
12. Copy of Job description provided? YES NO
13. Ship specific watch keeping times/procedures explained? YES NO
14. Have you identified colour coding of garbage drums ? YES NO
| Date: | Joining Staff |
| Signature | |
| Verified: | Master: |
| Head of Dept | Print Name |
| Print Rank and Name | |
| Signature | Signature |
PAGE 1 OF 3
ONBOARD FAMILIARISATION
SHIP : Joining Staff: Name:
Rank:
ITEMS TO BE COMPLETED WITHIN 24 HOURS OF JOINING VESSEL
* Delete as necessary
1. Have you found where spare lifejackets/EEBD/Immersion suit are stowed? YES NO
2. Do you know where ALL liferafts are stowed? YES NO
3. Have you checked the equipment you personally will use at your
EMERGENCY STATION? YES NO
4. Have you checked the position of ALL firefigthing equipment
in the accommodation? YES NO
5. Have you checked the position of ALL firefighting equipment
at your normal place of work? YES NO
6. Have you checked where lifebuoys are stowed? YES NO
7. Have you studied LIFEBOAT & EMERGENCY STATION muster list? YES NO
8. Have you checked where Oil Spill equipment is stowed? YES NO
9. Do you know what to do if:
A person falls overboard? YES NO
If a fire or smoke is detected? YES NO
If a fire or a general alarm is sounded? YES NO
If the reply is NO, contact Officer in charge and asks for detailed information.
10. Have you understood ship specific Safety and Emergency
Procedure and arrangements? YES NO
11. Have you been made aware of your security duties & responsibilities? YES NO
12. Have you been shown the locations and been given instruction in the use
of the Ship Security Alert System? YES NO
13. Are you aware of the identity of the Ship Security Officer/SSAS? YES NO
| Date: | Joining Staff |
| Signature | |
| Verified: | Master: |
| Head of Dept | Print Name |
| Print Rank and Name | |
| Signature | Signature |
PAGE 2 OF 3
ONBOARD FAMILIARISATION
SHIP : Joining Staff: Name:
Rank:
ITEMS TO BE COMPLETED WITHIN 7 DAYS OF JOINING VESSEL
* Delete as necessary
1. Have you checked where the FIRST AID & MEDICAL EQUIPMENT
is situated?
2. Have you checked instructions on liferafts? YES NO
YES NO
3. Could you find your way in darkness, from your cabin and place
of work to nearest exit to deck? YES NO
4. Have you read the operating instructions on ALL types of
FIRE EXTINGUISHERS onboard? YES NO
5. Have you read the vessel Training Manual situated in Public areas?
(Messroom, Smoking Room)? YES NO
6. Are you aware of Garbage Disposal Policy aboard your vessel? YES NO
7. Are you aware of Company ‘s Quality Policy Statement, Safety &
Environmental Protection Policy, Drug & Alcohol Policy aboard your vessel? YES NO
8. Are you aware of reporting accidents, incidents and hazardous
occurrences? (via Safety Committee representatives or directly) YES NO
9. Are you aware about permits to work? YES NO
10. Have you discussed with the Safety Officer or your Head of Department
any points on which you were uncertain or did not fully understand? YES NO
11. Do you know how and where to contact the Duty Officer at any hour
of the day or night? YES NO
ITEMS TO BE COMPLETED BY DECK AND ENGINE OFFICERS
WITHIN 30 DAYS OF JOINING VESSEL
1. Have you read, understood and signed the acknowledgement sheet of
all Company Safety & Quality Management System manuals? YES NO
1a. Have you discussed with the Safety Officer or your Head of Department
any points on which you were uncertain or did not fully understand? YES NO
| Date: | Joining Staff |
| Signature | |
| Verified: | Master: |
| Head of Dept | Print Name |
| Print Rank and Name | |
| Signature | Signature |
PAGE 3 OF 3
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