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Application Form - (Engine Crew)
Personal Details | |||||||
Rank: | Motorman | Nationality: | Ukrainian | ||||
First Name: | Iukhym | Surname: | Simchenko | ||||
Father’s Name: | Oleksandr | Requested Salary: | 900 USD | ||||
Date of birth: | 02.12.1983 | Place of birth: | Ukraine | ||||
Telephone: | Nearest Airport: | Odesa,Ukraine | |||||
Mobile Phone: | +380959242373 | Weight (Kg): | Shoes size: | ||||
E-mail: | efim-simchenko@yandex.ru | Height (Cm): | Overall size: | ||||
Smoker (Y / N): | N | (Y) Yes or (N) No | Marital Status: | Single | No. of children: | ||
Skype Address: | fima1331 |
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Home Address: | 13, Fortechna str., Izmail,Odessa reg., Ukraine | ||||||
Knowledge of English language (1-5): | 1. Very good 2. Good 3. Satisfactory 4. Fair 5. Poor | ||||||
Knowledge of Personal Computer (1-5): | 1. Very good 2. Good 3. Satisfactory 4. Fair 5. Poor | ||||||
Next of Kin | |||
Surname: | Simchenko | Name: | Anna |
Relationship: | Mother | Telephone: | +380955649301 |
Home Address: | 13, Fortechna str., Izmail Odessa reg., Ukraine |
Travel Documents | Number | Place of Issue | Issued on | Expires on |
National Passport: | ET 103310 | Ukraine | 13.07.2011 | 13.07.2021 |
Seaman’s Book: | AB 525565 | Ukraine | 09.07.2013 | 09.07.2018 |
US Visa | ||||
Schengen Visa |
Name of Marine School Attended | Qualification or Diploma | From | To |
Izmail seafarers training centre “Marine Pro Service” | Motorman | ||
Odessa Maritime College after Marinesko | Junior Specialist (3-rd eng) |
License(s) Held | Limitation(s) on KW (if any) | Grade/Class of license |
STCW Certificates | Number | Place of Issue | Issued on | Expires on |
Qualified Motorman Certificate | 00153/2013/01 | Ukraine | 03.06.2013 | N.A. |
Endorsement STCW | 00153/2013/01 | Ukraine | 03.06.2013 | 31.12.1016 |
Basic Safety Training (A-VI/1) | 30121/2014-A | Ukraine | 10.12.2014 | 10.12.2019 |
Prof. in Survival Craft& Rescue Boats (A-VI/2-1) | 22740/2014-A | Ukraine | 10.12.2014 | 10.12.2019 |
Prof. in Fast Rescue Boats (A-VI/2-2) | ||||
Advanced Fire Fighting (A-VI/3) | 20475/2014-A | Ukraine | 10.12.2014 | 10.12.2019 |
Medical First Aid (A-VI/4-1) | 11632/2014-A | Ukraine | 10.12.2014 | 10.12.2019 |
Ship’s Medical Care (A-VI/4-2) | ||||
Dangerous & hazardous cargo (B-V/4, B-V/5) | 14186/2014-A | Ukraine | 10.12.2014 | 10.12.2019 |
Ro-Ro passenger ships (A-V/2) | ||||
Maint. of Electrical & Electronic Engineering | ||||
Engine-room resource management | 7466/2014-A | Ukraine | 10.12.2014 | 10.12.2019 |
Security-Related Training and Instruction for All Seafarers | 22969/2014/AT | Ukraine | 09.09.2014 | 09.09.2019 |
Designated Security Duties of Shipboard Personnel (A-Vl/6) | 30266/2014/AT | Ukraine | 11.09.2014 | 11.09.2019 |
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Tanker Certificates: | Number | Place of Issue | Issued on | Expires on |
Oil Tanker familiarization (A-V/1, 2-7) | ||||
Oils Tanker advanced (A-V/1, 9-14) | ||||
Chemical Tanker familiarization (A-V/1,2-7) | 3179/MPS | Ukraine | 26.10.2012 | 31.12.2016 |
Chemical Tanker advanced (A-V/, 16-21) | ||||
LPG familiarization (A-V/1, 2-7) | ||||
LPG advanced (A-V/1, 23-34) | ||||
Crude oil washing | ||||
Inert gas system | ||||
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Special Training Certificates | Number | Place of Issue | Issued on | Expires on |
DP Maintenance Course | ||||
BOSIET | ||||
HUET | 08/2015-A | Ukraine | 04.02.2015 | 04.02.2020 |
Basic H2S Course | 10/2015-A | Ukraine | 04.02.2015 | 04.02.2020 |
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Medical Certificates: | Number | Place of Issue | Issued on | Expires on |
Physical Examination | Ukraine | 20.02.2015 | 20.02.2016 | |
Yellow Fever Vaccination | ||||
Cholera Vaccination | ||||
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Previous Sea Service (Please start with lasted contracts) | ||||||||
# | From | To | Vessel | Flag | GRT | Type | Position | Company |
22.02.2014 | 19.08.2014 | Rawabi 11 | Singapore | AHTS | Oiler | Rawabi Swiber.Offshore Services | ||
15.11.2012 | 18.01.2013 | Temixron 2 | Sierra Leone | General Cargo | Motorman-apprentice | Temixron S.A | ||
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# | Main Engine Maker/Model | Engine Stroke | Main Engine KW | Aux. Engine Maker/Number | Aux. Engine H.P. / KW | UMS (Yes/No) |
Niigata / 8L28HX | CAT / C18 | 550 KW |
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Дата добавления: 2015-08-27; просмотров: 21 | Нарушение авторских прав
| <== предыдущая лекция | | | следующая лекция ==> |
| Итого стоимость деталей = 3 400,00 рублей | | |
