Personal particulars. Documents and certificates. Date of issue. Vessel’s. Main engine. Ship-owner/Manager
SEAMAN’S EMPLOYMENT APPLICATION FORM
Position applied for:
| 2nd engineer
| Second choice (if any):
| 2nd engineer
| Available from:
| 01. 08. 2016
| Family name:
| Svislotskiy
| First name:
| Sergey
| | | | | | | | |
Date of birth:
| 20/03/1982
| Place of birth:
| Lithuania
| Nationality:
| Ukrainian
| Marital status:
| married
| Color of hair:
| Brown
| Color of eyes:
| blue
| Height (cm):
|
| Weight (kg):
|
| Size:
| 2xl
| Shoes:
|
| | | | | | | | | |
Personal particulars
Name of father: ____Anatoliy_________ Name of mother: ___Larisa____________ Name of spouse: ____Vasilina_____
Children under 18 (name/date of birth): ___Bogdan / 04/05/2011__________________________________________________
Home address:
Mariupol, Osoaviahima st. 28
Telephones: +380983769365
Next of Kin: Surname_____Svislotskaya________Name__Vasilina___________ Relationship_____wife____________
Address/Telephones
Mariupol, Osoaviahima st. 28 +380983137446
Notes:
Documents and certificates
Documents
| No
| Place of issue
|
Date of issue
| Valid until
| Seaman’s passport
| AB457586
| Mariupol SCP
| 15. 08. 2012
| 15. 08. 2017
| Civil travel passport
| EX347185
|
| 6. 08. 2013
| 06. 08. 2023
| Civil passport
| BB451832
| Volodarskoe
| 27. 05. 1998
| ID№3002906919
| | | | | | | CertificatesofCompetency
| Grade
| No
| Place of issue
| Date of issue
| Endorsement valid until
| National
| 2nd engineer
|
| Taganrog
| 14. 06. 2016
| 31. 05. 2021
| Liberia
|
|
|
|
|
| Name of Marine School (Academy): _State Marine University of Ushakov, Rostov-na-Don__________ Graduated on _2012_
STCW Certificates
| No
| Date of issue
| Valid until
| Basic safety/survival at sea
|
| 31. 05. 2016
| 31. 05. 2021
| GMDSS
|
|
|
| ROPS, ARPA
|
|
|
| Advanced fire-fighting
|
| 09. 06. 2016
| 09. 06. 2021
| Proficiency in survival craft
|
| 03. 06. 2016
| 03. 06. 2021
| Medical care / First aid
|
| 08. 06. 2016
| 08. 06. 2021
| Dangerous cargo (Hazmat)
|
| 02. 06. 2016
| 02. 06. 2021
| Security officer
|
| 02. 06. 2016
| 02. 06. 2021
| Safety officer
|
|
|
| A-VI/6-2 (off-s), A-VI/6-1(ratings)
|
|
|
| Yellow fever
|
| 01. 04. 2009
| 01. 04. 2019
|
Rank
|
Vessel’s
|
Main engine
|
Ship-owner/Manager
| From (mm. yy)
| To (mm. yy)
| Name
| Flag
| Type
| DWT
| Type
| HP
| 4th engineer
| Swansea
| Marshall Is
| Bulk Carrier
|
| MAN
|
| Norbulk Shipping UK ltd
| 11. 12. 2015
| 15. 04. 2016
| 4th engineer
| RAINBOW QUEST
| Gibraltar
| Bulk Carrier
|
| MAN
|
| Norbulk Shipping UK ltd
| 01. 04. 2015
| 30. 07. 2015
| 3rd engineer
| Medazov Julia
| St Vincent Grenadine
| Container ship
|
| MAK
|
| Medazov Rosa Co Ltd
| 09. 12. 2013
| 06. 12. 2014
|
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| Наличие справок о плавании и отзывов о работе приветствуется
Notes: U. S. visa expiration date 18. 10. 2025
|