Application Form (Officer) Position: 3rd officer

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Application Form (Officer) Position: 3^rd officer

Name: Maksym	Surname: Semenchenko
Date of birth: 21.11.1992	Place of birth: Kherson
Permanent address: I.Kylika st.132, 135
Phone: [phone]
Passport (OVIR) №:: ET472642	Place of issue:6511	Date of issue:24.11.11	Valid until: 24.11.21
Seaman’s book №: AB452304	Place of issue:Port Sevastopol	Date of issue:11.05.11	Valid until:: 04.05.16
Citizenship: Ukrainian	Expiry date of U.S. visa:
Marital Status:	Married Single + Divorced Widower
Next of kin: (name, pas. No)
Supported children under age of 18	1.
(name, surname, date of birth)	2.
Knowledge of English language:	Very good Good + Satisfactory Fair Poor
Other language knowledge:

Education:	Qualification:	No Diploma	Date of Issue
College:		XE 45631423	03.07.2013
Academy:

Certificates of STCW 78/95	No.	Place	Date of issue	Expiry date
CERTIFICATE OF COMPETENCY	10233/2015/11	Port kherson	27.01.2015	27.01.2020
ENDORSEMENT	10233/2015/11	Port Kherson	27.01.2015	27.01/2020
Basic Safety Training		USTC	03.12.2014	03.12.2019
Proficiency in Survival Craft		USTC	03.12.2014	03.12.2019
Proficiency in Fast Rescue Boats		USTC	03.12.2014	03.12.2019
Advanced Fire Fighting		USTC	03.12.2014	03.12.2019
Medical First Aid		USTC	03.12.2014	03.12.2019
Medical Care
GMDSS Certificate	10232/2015/11	Port Kherson	27.01.2015	27.01.2020
GMDSS Endorsement	10232/2015/11	Port Kherson	27.01.2015	27.01.2020
Radar Observation & Plotting		USTC	03.12.2014	03.12.2019
Automatic Radar Plotting Aids
Dangerous & Hazardous Cargoes		USTC	03.12.2014	03.12.2019
Hazardous materials
Ships Safety Officer
Ships Security Officer
Isolating Breathing Apparatus
RO-RO Passenger Ship
RO-RO Ship
Oil Tanker Familiarization
Oil Tanker Specialized Training
Gas Tanker Familiarization
Gas Tanker Specialized Training
Chem. Tanker Familiarization
Chem. Tanker Specialized Training
Crude Oil Washing
Inert Gas Systems
Bridge Resource Management		USTC	03.12.2014	03.12.2019
Vapor Recovery Systems
Refresher & Updating
Maintenance of Electrical and Electronic Engineering
ISM

Sea service (during five last years):

Name of vessel	COMPANY	HP/DWT	Flag	Type	Position	Period of service
From	To
M/V Comanche	Polana		Malta	Dry cargo	AB	11.08.2012	29.12.2012
M/V Somia	KSSL		Iran	General cargo	AB	03.04.2014	02.10.2014

Experience at sea:

Knowledge Personal Computer (Yes / No):+

Medical Certificate №	Issued:	Place:	Exp.date:
Vaccination for cholera valid until:	Vaccination for yellow fever valid until: 20.03.2022

Ready to work from:_______________________

Your last salary –

Expected salary -

Date: ________________ Signature _____________________

Дата добавления: 2015-11-04