| 1. POSITION APPLIED FOR | Ordinary seaman/ deck cadet | |||||||||||
2. FAMILY NAME (as in Seaman’s Book) | fedorchenko | ||||||||||||
3. FIRST NAME (as in Seaman’s Book) | Dmytro | ||||||||||||
4. DATE OF BIRTH
| 27/11/1993 | 5. PLACE OF BIRTH | Odessa | ||||||||||
6. COMPLETE ADDRESS Kyiv. Mariny Cvetaevoy str/16-a | |||||||||||||
) | +380994486633 e-mail l3adger@ukr.net | ||||||||||||
7. MARITAL STATUS Single | 8. CITIZENSHIP | Ukraine | |||||||||||
9. NEXT OF KIN | |||||||||||||
a) Relationship | Good | d) Place of Residence Kyiv. Mariny Cvetaevoy str/16-a | |||||||||||
b) Family Name | Klimchuk | ) 0991971975 | |||||||||||
c) First Name | Svetlana | ||||||||||||
| e-mail polyana-skazok.com.ua | ||||||||||||
10. OTHER PERSONAL DATA
a) Height 190 | b) Weight 70 | c) Boots Size 43 | d) Overall Size 48 | |
e) Color of Eyes blue | f) Color of Hair bright | |||
11. MARITIME EDUCATION
Educational institution | Specialty | Place | Period of Studies | |
From | To | |||
Academy | sailor | ONMA |
12. CERTIFICATES OF COMPETENCY
Grade / Class/STCW Code | Number | Date of Issue (DD.MM.YY) | Date of Expire (DD.MM.YY) | Country | |
Certificate of Competence: ordinary seaman | 04.09.2012 | Ukraine | |||
Endorsement: | ordinary seaman | 00397 | 04.09.2012 | Ukraine | |
Basic Safety Course (VI/1) | 207466c | 09.12.2011 | 09.12.2016 | Ukraine | |
Advanced Fire Fighting (VI/3) |
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Medical First Aid (VI/4-1) Medical Care (VI/4-2) |
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Survival Craft and Rescue boats (VI/2-1) | 12.07.2012 | 31.12.2016 | Ukraine | ||
Proficiency in Fast Rescue Boats (VI/2-2) |
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Tankerman Oil Familiarization Advanced |
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Tankerman Chemical Familiarization Advanced |
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Tankerman Gas Familiarization Advanced |
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ARPA Operational | 535c | 06.06.2014 | 07.06.2019 | Ukraine | |
GMDSS General Operator | 06.06.2014 | Ukraine | |||
Bridge Engine Resource Management |
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Maneuvering & Ship Handling |
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Welder Electro Gas TIG |
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ECDIS |
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Ship Security duties | 10.08.15 | 10.08.2020 | Ukraine | ||
13. PASPORTS AND VISAS 14. MEDICAL CERTIFICATE AND VACCINATIONS
Type | Country | Serial Number | Date of Issue (DD.MM.YY) | Date of Expire (DD.MM.YY) |
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| Date of Issue (DD.MM.YY) | Date of Expire (DD.MM.YY) |
National Passport
| Ukraine | Ap442328 | 08.12.2009 |
| Medical Certificate | 5.09.2015 | 5.09.2016 | |
Tourist / Travel Passport
| Ukraine | ep303942 | 28.08.2012 | 28.08.2022 |
| Drug & Alco Test Certificate |
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Seaman's Book / Seaman’s Passport
| Ukraine | ab486919 | 17.09.2012 | 17.09.2017 |
| Yellow Fever Vaccination |
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Other Seaman’s Book
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Other Seaman’s Book
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US Visa C1/D |
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Schengen Visa |
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16. PREVIOUS SEA SERVICE
Owners or Managers | Vessel's name | Type of vessel | Flag | GRT | Kwt | Type of Engine | Rank | Sign-on (DD.MM.YY) | Sign-off (DD.MM.YY) |
SVF Ch F | MB-173 | TUG | Russia | Deck cadet | 07.10.2011 | 17.12.2011 | |||
SVF Ch F | Yenisey | Hosp. ship | Russia | Deck cadet | 20.06.2012 | 25.08.2012 | |||
SVF Ch F | Istrya | Motor vessel | Russia | Deck cadet | 25.06.2013 | 26.08.2013 | |||
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Дата добавления: 2015-11-04; просмотров: 19 | Нарушение авторских прав
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| Middle name Sergiiovych | | | Record of personal information and past experience |
