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Апликашка APPLICATION FORM (ENGINE)
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ХудшийЛучший 

APPLICATION FORM (ENGINE)

Position applied for _ Electrical Cadet _ _

Date of availability ____ _01.12.12_ _

NAME: Andrii

SURNAME: Ovcharenko

DATE/PLACE OF BIRTH: 15.07.1993/Ukraine, Kherson

NATIONALITY: Ukrainian

INTERNATIONAL PASSPORT: ET750026

ISSUED/VALID: 2902.12/28.02.22

SEAMAN’S BOOK: AB499430

ISSUED/VALID: 28.02.12/14.02.17

US VISA:

MOBILE NO: +380999022052

FOREIGN CREW EXPERIENCE: YES__ NO__

ENGLISH: GOOD___ AVERAGE___ POOR___

STCW CERTIFICATES

REGULATION

NUMBER

ISSUED / VALID

PLACE OF ISSUE

CERTIFICATE OF COMPETENCY

ENDORSEMENT

BASIC SAFETY TRAINING

A – VI / 1

19560/11KH

12.10.11/12.10.16

PROFICIENCY IN SURVIVAL CRAFT

A – VI / 2

14920/11KH

16.12.11/16.12.16

ADVANCED FIRE FIGHTING

A – VI / 3

MEDICAL CARE ON BOARD

A – VI / 4

MEDICAL FIRST AID

A – VI / 4

TANKER FAMILIARIZATION

V / 1

OIL TANKERS SAFETY

V / 1

GAS TANKERS SAFETY

V / 1

CHEMICAL TANKERS SAFETY

V / 1

CRUDE OIL WASHING

MARPOL-73/78

INERT GAS SYSTEM

MARPOL-73/78

HAZARDOUS CARGOES

B-V/4&B-V/5

ISM (INTERN. SEAMAN’S CODE)

A.1441 (18)

RO – RO PASSENGER SHIPS

A – V / 2

SHIP’S SAFETY OFFICER

SHIP’S SECURITY OFFICER

ELECTICAL & ELECTRONIC EQUIPMENT

BREATHING APPARATUS

SEA SERVICE

NAME OF VESSEL

NAME OF COMPANY

FLAG

 

TYPE OF VESSEL

Bunker

 

TYPE OF ENGINE

 

BHP (Kwt)

D.W.T.

RANK

DURATION OF

SERVICE

SB - 401

VIK

Ukraine

440 kvt

635 t.

El. cadet

FROM

TO

19.05.12

31.10.12

 

 

OTHER PASSPORTS

UKRAINIAN PASSPORT:

MP307175

ISSUED:

12.01.10

PANAMA PASSPORT:

ISSUED / VALID:

PANAMA ENDORSEMENT:

ISSUED / VALID:

LIBERIAN PASSPORT:

ISSUED / VALID:

LIBERIAN ENDORSEMENT:

ISSUED / VALID:

CYPRUS PASSPORT:

ISSUED / VALID:

CYPRUS ENDORSEMENT:

ISSUED / VALID:

ISSUED / VALID:

ISSUED / VALID:

 

PERSONAL DATA

MARITAL STATUS: MARRIED____ SINGLE_____ DIVORCED____ WIDOWED_____

WIFE’S NAME:

HOME ADDRESS: Kherson reg. , Bilozerka , 25 Sverdlova St.

NEAREST AIRPORT: Nikolaev

PHONE NO:

E- MAIL:

Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

MOBILE NO:

+38099022052

NEXT OF KIN:

mother

CONTACT NO:

ADDRESS OF THE NEXT OF KIN:

FATHER’S NAME:

Ovcharenko Valentin

MOTHER’S NAME:

Ovcharenko Svitlana

CHILDREN: SONS__ DAUGHTERS___

NAMES OF CHILDREN:

HEIGHT:

180

WEIGHT:

75

SHOES:

43

OVERALL SIZE:

L

EYE COLOR:

Blue

HAIR COLOR:

brunet

YELLOW FEVER:

LAST MEDICAL EXAMINATION:

05.04.12

MARLIN’S TEST:

%

PRE-SEA EDUCATION

NAME OF SCHOOL OR ACADEMY

DEPARTMENT

FROM

(YEAR)

TO

(YEAR)

Kherson Meritime College

Electrical engineering

2010

2013

 

 

I hereby affirm that all the information provided by me in this form is true and correct to the best of knowledge.

 

 

 

Date of signing Signature

 


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