Personal data / application form

PERSONAL DATA / APPLICATION FORM Position applied for ____ El.Engineer

Family Name: MYRZOIEV

Name: IEVGEN

Father's name: ILGAR

Date of birth: 28.08.1991

Place of birth: Ukraine

Nationality Ukrainian

Marital status: single

Address: Odesssa reg,kiliya.bolgradskaya 39

Nearest Airport: Odesssa ……………………………………………………………

Home phone:[phone]

E-mail: [e-mail]

Mobile phone: [phone]

Next of kin and relationship:MYRZOIEV ILGAR

Children (name & DOB):NIL

Next of kin’s address: Odesssa reg,kiliya.bolgradskaya 39

Next of kin tel:

Inter. P’port No: EH 075477

Issued: 22.06.2010

Valid: 22.06.2020

Place of issue: odessa

Seaman's book No: AB 531093

Issued: 23.07.2014

Valid: 23.07.2019

Place of issue: Izmail

Civil P’port No: KM 534982

Place of issue: Odesssa reg,city kiliya

Date of issue: 05.05.2008

USA visa No:

Issued:

Valid:

Place of issue:

TOSE:

MARLINS:

SEA GOING EXPERIENCE FOR THE LAST 7 YEARS

(MOST RECENT VESSEL LAST)

Name of vessel	Year of built	Company Owner / Ship Manager	Flag	Type of vessel	DWT / TEU	ME type / Model	BHP	Rank	From DD/MM/YYYY	To DD/MM/YYYY
AKKORD		Navigator	Ukraine	GeneralCargo		SHKODA		El.Engineer	23.12.2011	23.04.2012
AKUA		Aqvas limited	Cook islands	GeneralCargo		SHKODA		El.Engine	24.04.2012	03.10.2012
ZEEBONY		Kirazoglu shipping com	Comoros	GeneralCargo		MAK	2500 kw	El.Engine	23.10.2012	01.06.2013
ALBA		Alba Management Co.S.A.	Cook islands	GeneralCargo		M.A.N.B&W		Electrician	02.09.2013	05.06.2014
NORWIND		NTO Sgipping Gmbh& Co.kg	Antigua&Barbuda	GeneralCargo		WARTSILA 6L32	3754 HP	Electrician	01.08.2014	14.12.2014

Name of Maritime Institution attended	Address of institution	From	To	Degree of Diploma
Odessa maritime college fishing industry	Ukraine,odessa

STCW Certificates	Number	Issued	Valid	Place of issue	STCW Certificates	Number	Issued	Valid	Place of issue
Certificate of competency	11065/2014/01	10.07.2014		Izmail	GMDSS Endorsement
Endorsement	11065/2014/01	10.07.2014	10.07.2019	Izmail	Radar observer
Personal safety		23.06.2014	23.06.2019	Izmail	ARPA
Advanced fire fighting		23.06.2014	23.06.2019	Izmail	AIS course
Prof. in survival craft		23.06.2014	23.06.2019	Izmail	BTM course
Training for Personnel Serving on RO-RO Passenger ships	4/151/11	12.07.2011	12.07.2016	Illichivsk	ECDIS course
Medical care		23.06.2014	23.06.2019	Izmail	Security officer (ISPS)
Security Duties	27827/2014/AT	31.072014	31.07.2019	Izmail	Safety officer (ISM)
Tanker Familiarization	4/223/11	12.07.2011	12.07.2016	Illichivsk
Training for Personnel Serving on Passenger Ships other then RO-RO Passenger Ships	4/081/11	12.07.2011	12.07.2016	Illichivsk

Medical examination	Issued:30.08.2013	Valid:30.08.2014	Weight, kg:90	Height, cm:180
Drug & alcohol test	Issued: 30.08.2013	Valid: 30.08.2013	Eyes:blue	Hair: blond
Yellow fever	Issued: 14.07.2010	Valid:14.07.2020	Overall size:56	Safety shoes:43

Another States Seamen’s Books	Rank	Document No	Issued	Valid		Another States Certificates of competency	Rank	Document No	Issued	Valid
Liberia						Liberia
Panama						Panama
Antigua and Barbuda	EL.ENG		31.07.2014	30.07.2019

Дата добавления: 2015-08-27