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Personaldata.  SEASERVICE. Periodonboard. Ship’sname. Yearof. Vesseltype. Typeofengine. Company. Position: Engine cadet/Wiper/Oiler. LicenseandEndorsement. STCWCertificates

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APPLICATION FORM

Personaldata


 


Rank:                                  Eng. cadet / Wiper / Oiler                                                                                           WageExpectation:                                             1000

 

Home№
Street: Leonova
Apartment№:  
City: Odessa
Country: Ukraine
Mobilephone1№: +380931016108
Mobilephone2№:  
E-mailaddress: pavnovface@mail. ru

 

Personaldetails                                                                                                                                                     Seafarer'saddress

Surname: Novikov
Name: Pavel
Father'sname: Evgeniyevich
Dateofbirth: 31. 05. 1993
Countryofbirth: Ukraine
Nationality: Ukrainian
Maritalstatus: Single
Children(under18): no


 
Maritimeeducation

  Number Issue Expiry Place
Seaman’sBook AB 534407 07/08/2014 07/08/2019 Odessa, Ukraine
CivilTravelPassport EP 670448 18/01/2013 18/01/2023 Odessa, Ukraine
USAVisa        

 

Nameofinstitution Grade From To
Odessa National Maritime Academy Bachelor
ETC “Admiral” 2nd class motorman 01/10/2013 11/04/2014

Eyescolor: Brown Height(cm): Shoessize:
Haircolor: Jet black Weight(kg): Boilersuitesize: S

 

Physicalinformation

Healthlist —      
Yellowfever —      


 SEASERVICE

Periodonboard

Ship’sname

Yearof

build

DWT

Vesseltype

BHP

Typeofengine

Flag

Company

Rank

From To
12/02/2014 17/04/2014 Lyubov Fishing vessel 6ЧНСП 18/22 Ukraine " Liman" LTD Motorman- trainee
                     
                     
                     
                     
                     

 

English language knowledge: good


Position: Engine cadet/Wiper/Oiler

 

LicenseandEndorsement

  Grade Number Issue Expiry Place

 

  Grade Number Issue Expiry Place
Certificateof Competency Second class motorman 12033/2014/11 09/10/2014 permanent Kherson, Ukraine GMDSS License          
Endorsement           GMDSS Endorsement          

 

STCWCertificates                                                                                                    AnotherStatesSeaman'sBookandLicenses

  Number Issue Expiry Place

 

  Number Issue Expiry Place
BasicSafety(A-VI/1) 6023/2014-A 13/03/2014 13/03/2019 Odessa, Ukraine A& BLicense       —
Proficiencyinsurvival craft(A-VI/2)         A& BSeaman'sbook       —
Advancedfire fighting(A-VI/3)         BahamasLicense       —
Medicalfirstaid (A-VI/4) 2459/2014-A 13/03. 2014 13/03/2019 Odessa, Ukraine BahamasSeaman'sbook       —
Medicalcare (A-VI/4)         CyprusLicense       —
HazardousCargoes(B-V/bandB-V/c)         CyprusSeaman'sbook       —
RadarNavigation, Radar Plotting& useofARPA         GermanLicense       —
Shipsecurityofficer (ISPSCode)         GermanSeaman'sbook       —
Shipsafetyofficer (ISMCode)         LiberianLicense       —
Bridgeteammanagement         LiberianSeaman'sbook       —
Training for designated security duties (A-VI/6-2)         MarshallIsland License       —
Other         MarshallIsland Seaman'sbook       —

 

Pleasecompletethefollowinginformationfromprevioustwocompaniesforreferences

Crewingcompany1   Crewingcompany2  
Address   Address  
Personincharge   Personincharge  
Phonesnumbers   Phonesnumbers  

 


 


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