PERSONAL INFORMATION

                                      APPLICATION FORM

POSITION(S):

OILER

                                                                              PERSONAL INFORMATION

SURNAME:

Petrov

FIRST NAMES:

Yurii

DATE OF BIRTH:

03. 11. 1990

PLACE OF BIRTH:

Ukraine

NATIONALITY:

Ukrainian

MARITAL STATUS:

Single

ENGLISH LEVEL

POOR

SATISFACTORY

GOOD

EXCELLENT

WEIGHT:

HEIGHT:

TELEPHONE NUMBERS:

066 542 76 34

EYES COLOR:

HAIR COLOR:

ADDRESS:  Ukraine, Odesa region, Berezovka, Gvardeiskaya street, 51

OVERALLS:

SHOES:

EDUCATION AFTER SCHOOL

NAME OF INSTITUTION:

Odessa*s professional collage of maritime transport

NEXT OF KIN

RELATION:

mother

SURNAME, FIRST NAMES:

Zacharchich  Valentina

TELEPHONE NUMBERS:

066 146 96 11

ADDRESS: Ukraine, Odesa region, Berezovka, Central street, 41

DOCUMENTS

NAME

NUMBER

ISSUING DATE

EXPIRATION DATE

NATIONAL PASS

КМ 466045

10/05/2015

------

INTERNATIONAL PASS

FB604606

30. 06. 2015

30. 06. 2025

UKR SEAMAN’S BOOK

AB 554882

02. 09. 2015

02. 09. 2020

SERTIFICATES

SAFETY BASIC TRAINING AND INSTRUCTION

18. 06. 2015

18. 06. 2020

SURVIVAL CRAFT and REUSCUE BOATS

ADVANCED FIRE FIGHTING

05. 09. 2014

05. 09. 2019

SECURITY AWARENESS TRAINING FOR ALL SEAFARERS and DESIGNATED SECURITY DUTIES

30. 06. 2015

30. 06. 2020

CERTIFICATE OF COMPETENCY

ABLE SEAFARER ENGINE

11884/2015/01

23. 07. 2015

---------

SEAGOING EXPERIENCE (LAST CONTRACTS)

VESSEL

FLAG

OWNER/

MANAGMENT

TYPE

DWT

ENGINE

BHP

RANK

FROM

TO

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