4, Kerchenskaya str, off 1, Sevastopol, Crimea,

AV MARINE LTD

4, Kerchenskaya str, off 1, Sevastopol, Crimea,

299011 Russia

Phone [phone] Fax [phone]

Mobile [phone]
e-mail: [e-mail]

Rank: OS

APPLICATION FOR EMPLOYMENT

1. Personal Data

Surname Stepurkin	Name Viacheslav	Father's Name Valeriovich	Permanent address:
Kherson Nikolskoye village Partizanskaya str. 25
Citizenship Ukrainian	Date of birth 12.06.1994	Place of birth Kherson	Phone:[phone]
Mobile / e-mail [e-mail]
Document	No.	Date of issue	Place of issue	Valid until
Passport (Travelling)	EX 137961	11/06/13	Kherson	11/06/23
Seaman’s Book	AB 513254	20/02/13	Kherson	13/02/18
Liberian S. B.
Panamanian S. B.
Russian Civil Pasport
Other

1. Marine Education

Full Name of School	From	Till
KHERSON MARITIME LYCEUM
KHERSON MARITIME COLLEGE

1. Certificates/Courses

Highest Competency certificate held:

Issuing authority	Grade/ STCW’95 Capacity	Certificate No.	Date/Place issued	Valid until
National Certificate of Comp
STCW 78/95 Endorsement
Liberian
Panamanian
Other

Dangerous cargo certification

A. Endorsement on national certificate	Number	Date/ Place issued	Valid until
Oil tanker V/1
Liquefied gas tanker V/1
Liquid Chemical tankerV/1
B. Courses	Training center	Number	Date/ Place issued	Valid until
Crude Oil Washing
Inert Gas Systems
Hazardous Cargoes B-V/4;5
Tanker Special. (Oil) V/1-2
Tanker Special.(Chem)V/1-2
Tanker Special.(L Gas)V/1-2
Tanker familiar. (Oil) V/1
Tanker familiar. (Chem)V/1
Tanker familiar. (Gas) V/1
Ro-Ro passenger V/2-3

Other Certificates held and courses attended (include Liberian Special Qualification)

Courses/Certificate	Certificate N	Date/ Place issued	Valid until
Basic safety training and instruct.	VI/I	5648/MPS	24.02.2012	24.02.2017
Proficiency in Survival Craft	VI/2	6466/MPS	01.02.2013	01.02.2018
Fire Fighting advanced	VI/3
Medical first aid	VI/4-1
Medical care	VI/4-2
ARPA Radar Observer Radar Simulator
GMDSS GENERAL	IV/2
GMDSS RESTRICTED
GMDSS ENDORSEMENT
Bridge Team mgmt
Disignated security duties of shipboard personnel		12774/MPS	17.01.2014	17.01.2019
ECDIS	VI/4-1
Electrical & Electronic equipment
Ship security officer (ISPS code)
Ship security familiarization
Security- related training and instruction for all seafarers		7932/MPS	17.01.2014	17.01.2019
Ship safety officer IMOA741(18)
Yellow Fever Vaccination Certif.			12.06.2015	12.06.2025

1. Visas

Country	Visa Type/Class	No.	Date Issued	Place Issued	Valid Until
USA
Shengen

1. Sea Experience: (Last 5 years - Most recent experience on top line)

Company	Vessel	Flag	Vessel Type	DWT	HP	Engine type	Rank	Date from	Date to
DP-Kherson Commercial Sea Port	т.х VOLGO BALT-218		General cargo			1030 kwt	OS	10.05.2013	10.09.2013
DAO HK Dalmoreprodukt	Piotr Jkitnikov	Russia	1. rRefrigiretion			6480kwt	OS	06.05.2014	24.04.2015

4. General

(A) Have you ever been denied a foreign visa? If yes, state which country and reason.

(B) Have you been the subject of a court of inquiry or involved in a marine accident?

(C) Nearest airport

ODESSA

(D) Knowledge of language (good, fair, satisfactory, standard marine) average knowledge Last salary: ______900_____ USD

	Spoken	Written	Understanding
English

Any additional useful info

Banana/Fruits Experience
Next of kin and relationship
High / Weight / Shoes / Size	187/85/45/120

Date/ signature Date availability for service

Дата добавления: 2015-11-04