Application form - Sea Shipping

APPLICATION FORM (Ship)

1The Ship

2The applicant

3Address details

4Statement of agreement

The ship
The applicant below (shipowner or their representative) hereby applies for a Green Award ship certification and office audit/ship survey related thereto for the following ship.
Ship name
Flag
IMO number
Ship type
Delivery Date
DD dash MM dash YYYY
Classification society
Registered owner
ISM Manager
Gross tonnage
Deadweight
Ship’s e-mail address
Has the vessel in the last 2 years been detained by Port State Control?
- Yes
- No
(For cross reference purpose only and will not have immediate influence on the certification)
Has the vessel in the last 2 years been involved in environmental or relevant safety violations?
- Yes
- No
(For cross reference purpose only and will not have immediate influence on the certification)
Has the vessel in the last 2 years been involved in an incident?
- Yes
- No
(For cross reference purpose only and will not have immediate influence on the certification)
Remarks
(Sister vessels, preferred onboard ship survey date / office audit date)

Address details
Skip if the office is certified and there have been no changes
Is your company Green Award certified?
- Yes, fill in below only when there are changes or specific requests (i.e. invoice)
- No, fill in below (an office audit conducted by Green Award is required before a ship survey can take place)
Street Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Postal Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Invoicing details
Contact person
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Invoice email
VAT-number
IBAN-number
SWIFT-code
Remarks
(Any specific requests for address / or invoicing details)