APPLICATION FORM (ENGINE)
Position applied for _________ _________
Date of availability ___ ______
NAME: Anton | SURNAME: Madin | |||||
DATE/PLACE OF BIRTH: 06.05.1991 |Energodar | NATIONALITY: Ukrainian | |||||
INTERNATIONAL PASSPORT: ET574955 | ISSUED/VALID: 28.12.2011 | 28.12.2021 | |||||
SEAMAN’S BOOK: AB463004 | ISSUED/VALID: 05.05.2011 | 29.04.2016 | |||||
US VISA: n/a | MOBILE NO: +380992769812 | | |||||
FOREIGN CREW EXPERIENCE: NO | ENGLISH: AVERAGE | |||||
Mail: madin.a@bk.ru | Skype antoiiika2 | |||||
STCW CERTIFICATES | REGULATION | NUMBER | ISSUED / VALID | PLACE OF ISSUE | ||
CERTIFICATE OF COMPETENCY | 3rd engineer | 00131/2014/11 | 10.02.2014 | Kherson | ||
ENDORSEMENT | 3rd engineer | 00131/2014/11 | 10.02.2014 | Kherson | ||
BASIC SAFETY TRAINING | A – VI / 1 | 19581/11KH | 23.11.2011/23.11.2016 | Kherson | ||
PROFICIENCY IN SURVIVAL CRAFT | A – VI / 2 | 15322/12KH | 23.03.2012/23.03.2017 | Kherson | ||
ADVANCED FIRE FIGHTING | A – VI / 3 | 9736/13KH | 25.01.2013/25.01.2018 | Kherson | ||
MEDICAL FIRST AID | A – VI / 4 | 7945/13KH | 25.01.2013/25.01.2018 | Kherson | ||
HAZARDOUS CARGOES | B-V/4&B-V/5 | 0711/2013KH | 12.07.2013/12.07.2018 | Kherson | ||
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SEA SERVICE
NAME OF VESSEL | NAME OF COMPANY | FLAG | TYPE OF VESSEL | TYPE OF ENGINE | BHP (Kwt) | D.W.T. | RANK | DURATION OF SERVICE | |
FROM | TO | ||||||||
m/v ‘Stanislav Kosior’ | Capital Shipping Company | UA | BULK | SKL NVD | Cadet Engine | 12.04.12 | 20.11.12 | ||
m/v ‘OM-106’ | KSMA | UA | PS | Cadet Engine | 05.05.11 |
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