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Application Form (Officer) Position: 3rd officer
Name: Maksym | Surname: Semenchenko | ||||
Date of birth: 21.11.1992 | Place of birth: Kherson | ||||
Permanent address: I.Kylika st.132, 135 | |||||
Phone: +380951534068 | |||||
Passport (OVIR) №:: ET472642 | Place of issue:6511 | Date of issue:24.11.11 | Valid until: 24.11.21 | ||
Seaman’s book №: AB452304 | Place of issue:Port Sevastopol | Date of issue:11.05.11 | Valid until:: 04.05.16 | ||
Citizenship: Ukrainian | Expiry date of U.S. visa: | ||||
Marital Status: | Married Single + Divorced Widower | ||||
Next of kin: (name, pas. No) |
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Supported children under age of 18 | 1. | ||||
(name, surname, date of birth) | 2. | ||||
Knowledge of English language: | Very good Good + Satisfactory Fair Poor | ||||
Other language knowledge: |
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Education: | Qualification: | No Diploma | Date of Issue |
College: |
| XE 45631423 | 03.07.2013 |
Academy: |
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Certificates of STCW 78/95 | No. | Place | Date of issue | Expiry date |
CERTIFICATE OF COMPETENCY | 10233/2015/11 | Port kherson | 27.01.2015 | 27.01.2020 |
ENDORSEMENT | 10233/2015/11 | Port Kherson | 27.01.2015 | 27.01/2020 |
Basic Safety Training | USTC | 03.12.2014 | 03.12.2019 | |
Proficiency in Survival Craft | USTC | 03.12.2014 | 03.12.2019 | |
Proficiency in Fast Rescue Boats | USTC | 03.12.2014 | 03.12.2019 | |
Advanced Fire Fighting | USTC | 03.12.2014 | 03.12.2019 | |
Medical First Aid | USTC | 03.12.2014 | 03.12.2019 | |
Medical Care | ||||
GMDSS Certificate | 10232/2015/11 | Port Kherson | 27.01.2015 | 27.01.2020 |
GMDSS Endorsement | 10232/2015/11 | Port Kherson | 27.01.2015 | 27.01.2020 |
Radar Observation & Plotting | USTC | 03.12.2014 | 03.12.2019 | |
Automatic Radar Plotting Aids | ||||
Dangerous & Hazardous Cargoes | USTC | 03.12.2014 | 03.12.2019 | |
Hazardous materials | ||||
Ships Safety Officer | ||||
Ships Security Officer | ||||
Isolating Breathing Apparatus | ||||
RO-RO Passenger Ship | ||||
RO-RO Ship | ||||
Oil Tanker Familiarization | ||||
Oil Tanker Specialized Training | ||||
Gas Tanker Familiarization | ||||
Gas Tanker Specialized Training | ||||
Chem. Tanker Familiarization | ||||
Chem. Tanker Specialized Training | ||||
Crude Oil Washing | ||||
Inert Gas Systems | ||||
Bridge Resource Management | USTC | 03.12.2014 | 03.12.2019 | |
Vapor Recovery Systems | ||||
Refresher & Updating | ||||
Maintenance of Electrical | ||||
ISM | ||||
Sea service (during five last years):
Name of vessel | COMPANY | HP/DWT | Flag | Type | Position | Period of service | |
From | To | ||||||
M/V Comanche | Polana | Malta | Dry cargo | AB | 11.08.2012 | 29.12.2012 | |
M/V Somia | KSSL | Iran | General cargo | AB | 03.04.2014 | 02.10.2014 | |
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Experience at sea: | Knowledge Personal Computer (Yes / No):+ |
Medical Certificate № | Issued: | Place: | Exp.date: | |
Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 20.03.2022 | |||
Ready to work from:_______________________
Your last salary –
Expected salary -
Date: ________________ Signature _____________________
Дата добавления: 2015-11-04; просмотров: 19 | Нарушение авторских прав
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