Position applied for: Motorman, Wiper, Cadet

APPLICATION FORM
Position applied for: Motorman, Wiper, Cadet Minimum acceptable salary: 200$ Remarks: No
Surname	Kovalskyi
name	anton
Father's Name	Nikolaevish
Date and place of birth: 10.01.1990 Nikolaev
Address: Odessa, Segedskaya street 15 app.5
Home (	Mob [phone]	Personal civil code:
E-Mail: [e-mail]	SKYPE:toxa199017	ICQ:
Weight 90	Height 172	Overall XL	Shoes 42	Eyes Green	Hair Black
USA visa valid:	Medical card valid: 28.06.2015	Yellow Fever valid: 14.06.2014
Title of the document	№	Date of issue	Expire date	Place of issue
Seaman's book	AB 527676	13.05.2014	13.05.2019	Odessa
National passport	EP 252742	08.09.2006		Nikolaev
Foreign passport	ER 169459	14.02.2014	14.02.2024	Nikolaev
Cyprus passport
Panama passport
Other passport
Certificate of competency	10117/2014/07	27.03.2014	27.03.2024	Nikolaev
Rank	Motorman Second Class
Endorsement
Others Professional license
Rank
Endorsement
G.M.D.S.S. General Operator (A-IV/2) Certificate
G.M.D.S.S. General Operator (A-IV/2) Endorsement
Basic Safety Training and Instruction (НБЖС) (A-VI/1)		27.11.2013	27.11.2018	Odessa
Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2)		11.03.2015	11.03.2020	Odessa
Advanced Fire Fighting (A-VI/3)		11.03.2015	11.03.2020	Odessa
Carrying dangerous & hazardous cargo (B-V/4, B-V/5)
Radar Observation and Plotting (A-II/1,2)
Automatic Radar Plotting Aids (ARPA) (A-II/1,2)
Ship’s Medical Care (A-VI/4-2)
Medical First Aid (A-VI/4-1)
Ro-Ro passenger ships (A-V/2)
Refresher and updating courses (II/1)
Passenger ships other than Ro-Ro (A-V/3)		28.02.2014	28.02.2019	Odessa
Designated security duties of shipboard personnel		11.03.2015	11.03.2020	Odessa
SHIPS SAFETY OFFICER
SHIPS SECURITY OFFICER
Security – Related Training and Instruction For All Seafarers		28.02.2014	28.02.2019	Odessa
Familiarization course on ship and port facility security for crew
Training for seafarers with designated security dutes (A-VI/6-2)

Tanker Certificates:	№	Date of issue	Expire date	Place of issue
Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7)		28.02.2014	28.02.2019	Odessa
LPG carrier (Advanced and Familiarization, A-V/1, p.2-7)
Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7)		28.02.2014	28.02.2019	Odessa
Cargo equipment on Tankers (A-V/1, paragraph 1)
Crude oil washing
Inert gas system
Tanker Familiarization course

PREVIOUS SEA EXPERIENCE (FOR LAST 10 YEARS):

RANK	NAME OF THE VESSEL	TYPE VESSEL	YEAR OF BUILD	DWT	TYPE OF THE MAIN ENGINE	FROM	TILL	COMPANY (name, address, ()
FLAG	HP
Motorman	Mars	Bunkering Vessel				30.12.13	01.03.14	Illichevsk port
Ukraine
Motorman	Fort Azov	General Cargo				19.05.14	23.12.14	Valdex Trade LTD
SAINT KITTS & NEVIS

MARINE EDUCATION RECEIVED

NAME OF SCHOOL	FROM	TILL	TYPE OF DEGREE RECEIVED
Odessa Training center of seafarers - AVANT	29.08.13	07.03.14	motorman

ADDITIONAL INFORMATION

Marital status: married	married
Next of kin (Name, date of birth, address, phone #)	Katya
Odessa, Segedskaya street 15 app.5
	Home (:	Mob (: 0631372067

Level English test

English language knowledge	Excellent		Good		Satisfactory	۷	Poor
Computer proficiency	Excellent		Good	۷	Satisfactory		Poor

Откуда вы узнали о нашей компании

Знакомые

۷

Газета

Телевидение

Интернет

I, undersigned, confirm all above information to be true and correct to my best knowledge:

Date 15.05.2015 Signature of the Applicant

Дата добавления: 2015-08-27