S E A M A N ' s A P P L I C A T I O N F O R M

S E A M A N ' s A P P L I C A T I O N F O R M

A. SEAMAN'S PERSONAL DETAILS

POSITION TO APPLY FOR

A/B

NAME / SURNAME

Yadviga Vadym

NATIONALITY

Ukraine

MOB: [phone].930-20-34

MARITAL STATUS

MARRIED

YES X NO

CHILDREN

YES Х NO

NEXT OF KIN

Wife

SEAMAN'S PASSP NO.

AB 510213

ISS / VALID DATE

05.08.2013 – 05.08.2018

TRAV. PASSP NO.

AK 903879

ISS / VALID DATE

22.02.2006 – 22.0 2.2016

GRADUATED FROM

Odessa high vocational school of the maritime tourist service 2003 - 2005

Odessa's professional college of maritime transport 2006 - 2006

ENGLISH ABILITY

FLUENT

VERY GOOD

GOOD

FAIR

B. NATIONAL CERTIFICATION
CERTIFICATE	NUMBER	ISSUING - VALIDATION DATE	ISSUING PLACE
CERTIFICATE OF PROFICIENCY	10717/2014/08	04.08.2014
BASIC SAFETY		30.08.2013	30.08.2018
PROFICIENCY IN SURVIVAL CRAFT AND RESCUE BOATS		16.06.2014	16.06.2019
DANGEROUS SUBSTANCES		16.06.2014	16.06.2019
LAST MEDICAL		30.08.2013	30.08.2014
ADVANCED FIRE FIGHTING		21.08.2013	21.08.2018
TRANING FOR PERSONNEL SERVING ON PASSENGER SHIP		03.09.2013	03.09.2018
DESIGNATED SECURITY DUTIES OF SHIPBOARD PERSONNEL		27.12.2013	27.12.2018
SECURITY-RELATED TRAINING AND INSTRUСTION FOR ALL SEAFARERS		26.12.2013	26.12.2018
VACCINATIONS	YELLOW FEVER: DOI 09.03.2006 DOE 09.03.2016 CHOLERA: DOI………………………. DOE ……………………….

C. PREVIOUS SEA SERVICE
VESSEL	FLAG	TYPE/DWT	ENG/HP	RANK	S/ON	S/OFF	OWNERS
Fortune	Cook Island	General-cargo/ 3042		AB-Bosun	28.12.2014	13.06.2014	FORTUNE CORPORATION LTD.
Rokia Delmas	Monrovia	RO-RO/Cont. 32924		AB	10.12.2010	20.08.2011	Montely Marine LTD
Rokia Delmas	Monrovia	RO-RO/Cont. 32924		AB-Cook	20.12.2009	31.07.2010	Montely Marine LTD
Ustjuzhna	Ukraine	General-cargo/ 19240		AB	25.02.2009	05.07.2009	Ardemar Marine Ltd
Yuriy Dvuzhilniy	Ukraine	General-cargo/ 8000		AB-Steward	29.01.2009	24.02.2009	Ardemar Marine Ltd
Arya	Cambodia	General-cargo/ 2627		AB	07.05.2008	16.08.2008	Arkadiya Sh. Ltd
Jezabel-1	Cambodia	General-cargo/ 2649		AB	01.03.2008	05.05.2008	Arkadiya Sh. Ltd
Ocean-1	Cambodia	General-cargo/ 2650		Cook	20.03.2006	10.09.2006	Arkadiya Sh. Ltd

Дата добавления: 2015-08-27