Application form
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Surname Rogalya | First name Sergiy | Middle name Vladimir | |||||||||||||||||||
Permanent address: Mariupol Donetsk region pr.Stroiteley 67 | E-mail:luna_1811@mail.ru | ||||||||||||||||||||
Date of birth 21.04.1991 | Place of birth Beloyarskiy/Russia | Citizenship UKRAINE | Min.salary 500 USD | ||||||||||||||||||
Phone (home) +38097 281 67 14 | Phone (mob.) +38097 512 10 13 | Nearest Airport Dnipropetrovsk | |||||||||||||||||||
Marital status Single | Number/ age of children: one children, one year | ||||||||||||||||||||
Next of kin (name/relation):Irina Sotnik, civil wife | Next of kin (address):Mariupol, Stroiteley 67
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Colors of eyes: gray | Colors of hair: brown | Special marks: no | |||||||||||||||||||
Height:176 cm | Weight:72 kg | Overall size:50 | Shoes size:43 | ||||||||||||||||||
Knowledge of English (Fluent/Good/Satisfactory/Poor): Satisfactory | Other languages:no | ||||||||||||||||||||
Licenses & Certificates held | Date of issue | Date of expiry | Place of issue | ||||||||||||||||||
Certificate off competency | 22.06.2015 |
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Endorsement of certificate |
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Seaman’s passport | 02.06.2015 | 02.06.2020 | Mariupol | ||||||||||||||||||
Travel passport | 22.07.2015 | 22.07.2025 | Mariupol | ||||||||||||||||||
Basic safety | 15.04.2015 | 15.04.2020 | Mariupol | ||||||||||||||||||
Proficiency in survival craft & Rescue boats | 01.07.2015 | 01.07.2020 | Mariupol | ||||||||||||||||||
Designated security duties of shipboard personnel | 08.07.2015 | 08.07.2020 | Mariupol | ||||||||||||||||||
Security-related training and instruction for all seafarers | 25.06.2015 | 25.06.2020 | Mariupol | ||||||||||||||||||
GMDSS |
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RADAR |
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ARPA |
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Ship security officer (ISPS) |
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HAZMAT |
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Tanker certificate (Oil/Chemical/Gas) |
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US VISA |
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Foreign flag state licence |
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Foreign flag state seaman’s book |
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Graduated from | Date: | ||||||||||||||||||||
Yellow fever 08.08.2015 | Last medical examination | ||||||||||||||||||||
Details of previous sea service | |||||||||||||||||||||
Rank | Name of ship owner | Flag | Name of VSL | Type of VSL | Type of engine | DWT | BHP
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motorman | Mariupol sea trading port | Ukraine | Alamak | Tug |
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| 1.10.2009 | 1.12.2009 | |||||||||||||
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Date: 11.10.15 Signature ______________
Дата добавления: 2015-11-04; просмотров: 23 | Нарушение авторских прав
| <== предыдущая лекция | | | следующая лекция ==> |
| Проектна пропозиція на участь у конкурсі спільних українсько-латвійських науково-дослідних проектів | | | Application form (Анкета) |
