POSITION:__Ordinary Seaman____SALARY_____800____

APPLICATION FORM

POSITION:______Ordinary Seaman________________________________________________________________ SALARY _____800________________________

Surname:_Sionsky______________________________ ^Прізвище:^Сионский^________________________________________	Name:________Sergii_______________________________ ^Ім^’^я^:^Сергей^__________________________________________________	Father'sname:_________Sergiyovich__________________________________ ^По-батьков^і: ____Сергеевич__________________________________________________
Date of birth: 25.07.1991	Place of birth: Belgorod-Dnestrovsky	Nationality: Ukrainian	Nearest airport:Odessa international airport
Address (permanent): Belgorod-Dnestrovskiy 8,Pobeda str App.49	E-mail:[e-mail] skype: leon25k	Mobil: [phone]
S4 Point Test:	Marlins test:	CES 5.2.2.:	Visas:
Next of kin and relationship: Mom Lydmila Sionskaya	Marital status: single
Next of kin’s address: Belgorod-Dnestrovskiy 8,Pobeda str App.49 Next of kin tel: Mom [phone]	Next of kin’s phone:
Travel Passport: EK 436470	Issued: 21.08.2009	Valid: 21.08.2019	Place of issue: Odessa
Seaman's book: AB 377337	Issued: 27.10.2009	Valid: 27.10.2019	Place of issue: Port Kerch
Civil Passport: KM 558555	Issued: 22.08.2008	Place of issue: Belgorod-Dnestrovskiy	ID Code:3344307618
Education: Belgorod-Dniester marine fishing college Kerch sea fishing industry University 2006-2010 Diploma Number CK 39393343

SEA GOING EXPERIENCE FOR THE LAST 5 YEARS

(MOST RECENT VESSEL LAST)

Name of vessel	IMO number	Year of built	Company Owner/ Ship Manager	Flag	Type of vessel	DWT	Main engine/ kW	Rank	From dd, mm, yyyy	To dd, mm, yyyy
Sevastopol			Ltd. NHP	Ukraine	Motor ship		2x1260 h/p	OS	28.11.2009	01.09.210

CERTIFICATE OF COMPETENCY

Type of document	Grade	Number	Issued	Valid	Place of issue
Certificate of competency	Second class seaman	11869/2015/08	13/05/2015	No applying	Odessa

СERTIFICATES

Type of certificates	Number	Issued	Valid	Place of issue
Basic Safety Training (VI/1)	4655/2015-A	03.03.2015	03.03.2020	Odessa
Proficiency in survival craft & rescue boats (VI/2)	18145/2015-A	10.08.2015	10.08.2020	Odessa
Advanced fire fighting (VI/3)
Medical First Aid/Medical Care (VI/4)
Dangerous and Hazardous Cargoes (B-V/b,B-V/c)
Ship Security Officer (VI/5)
GMDSS endorsement
Radar Navigation (Radar & ARPA)
ECDIS
Security awareness training for all seafarers (A-VI/6-1)	1136/2015-A	03.03.2015	03.03.2020	Odessa
Designated security duties of shipboard personnel (A-VI/6-2)	6953/2015-A	10.08.2015	10.08.2020	Odessa
Yellow fever vaccination

PERSONAL PARTICULARS

Hair	Eyes	Height	Weight	Overall size	Shoes
Dark	brown			48-50

REFERENCES

Name of Company/ Crewing agency	Phone number	Contact person

С автоматизированной обработкой моих персональных данных указанных в анкете, их передачей (включая трансзаграничную) и хранением в целях трудоустройства согласен. Подпись__ ______

Дата добавления: 2015-11-04