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Permanent address: Kherson,Ayvazovskogo street,5-112



Application form

Ordinary Seamen(O/S)

Navigator

 

Surname Safonov

First name Mykyta

Middle name Viktor

Permanent address: Kherson,Ayvazovskogo street,5-112

E-mail: Safonov.Nikita.OS@mail.ru

Date of birth 16.04.1993

Place of birth Kherson

Citizenship

Ukrainian

Min.salary

-

Phone (home)

+38(0552) 51-40-53

Phone (mob.)

+38(099) 00-314-77

Nearest Airport

Odessa

Marital status (married/Single/Divorced):

Single

Number/ age of children:

-

Next of kin (name/relation):

Safonova Yana/mother

Next of kin (address):

Kherson,Ayvazovskogo street,5-112

Colors of eyes:

Green

Colors of hair:

Dark

Special marks:

-

Height: 175 cm

Weight: 81 kg

Overall size:

Shoes size: 41

Knowledge of English (Fluent/Good/Satisfactory/Poor): Good

Other languages: -

Licenses & Certificates held

Date of issue

Date of expiry

Place of issue

Certificate off competency

10.08.2012

01.06.2016

Kherson

Endorsement of certificate

10.08.2012

01.06.2016

Kherson

Seaman’s passport

09.04.2012

28.02.2017

Kherson

Travel passport

11.11.2011

11.11.2021

Kherson

Basic safety

28.03.2014

28.03.2019

Kherson

Proficiency in survival craft & Rescue boats

27.03.2014

27.03.2019

Kherson

Advanced fire fighting

21.03.2014

21.03.2019

Kherson

Med first aid / care on board

21.03.2014

21.03.2019

Kherson

GMDSS

11.03.2014

11.03.2019

Kherson

RADAR

18.04.2014

18.04.2019

Kherson

ECDIS

21.03.2014

21.03.2019

Kherson

Ship security officer (ISPS)

04.04.2014

04.04.2019

Kherson

HAZMAT

-

-

-

Tanker certificate (Oil/Chemical/Gas)

-

-

-

USA VISA

-

-

-

Foreign flag state licence

MP291458

-

Kherson

Graduated from: Bachelor

Date: 03.07.2014

Yellow fever (желтая лихорадка)(Date of Vaccination):

-

Last medical examination (Date of Expiry/Med Certificate):

23.10..2014

Details of previous sea service

Rank

Name of ship owner

Flag

Name of VSL

Type of VSL

Type of

 

DWT

BHP

 

From

To

 

Cadet

Kherson State Maritime Academy

Ukraine

OM-106

Passenger ship

   

440 kwt

24.09.2012

18.01.2013

OS

Onegoship

Belize

Kadmiy

General Cargo

   

2x662 kwt

22.06.2013

01.02.2014

OS

AtoBatC Shipping

Gibraltar

REYMAR

General Cargo

   

2200 kwt

05.11.2014

25.04.2015

                                           

 

Date: 15.05.2015 Signature: Safonov M.


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