Welding skills are! Do not smoke, do not drink.

S E A M A N ' s A P P L I C A T I O N F O R M

SEAMAN'S PERSONAL DETAILS

Welding skills are! Do not smoke, do not drink.

I like to be engaged in self-education and sports.

Quickly learn new skills!

Salary: 1000$

POSITION TO APPLY FOR

Cadet, OS, AB, or Junior Off.

CERTIFIED FOR

Navigator

NAME / SURNAME

Serhey Ihnatchenko

FATHER'S NAME

Andrey

MOTHER'S NAME

Elena Ihnatchenko

D. O. B. /P. O. B.

14. 06. 1991/Ukraine,

Nikolaev

NATIONALITY

Ukrainian

Height (in cm): 176

Weight (Kg): 70

Shoes size: 41

Parka size: 58

ADDRESS

Ukraine, Nikolaev, Lenina st. 189 flat 56

MOBILE No.:

PHONE No.:

+380939615392

SKYPE ADDRESS:

disorder999

MARITAL STATUS

MARRIED

YES q NO q

CHILDREN

YES q NO q

HOW MANY UNDER

18 YRS OLD ………

NEXT OF KIN

Ihnatchenko Anna

RELATION

whife

SEAMAN'S PASSP NO.

AB460025

ISS / VALID DATE

22. 07. 10/24. 02. 20

CIVIL PASSP NO.

ЕР283225

ISS / VALID DATE

24. 07. 07

Avir BIOMETRIC No.

FG620281

ISS / VALID DATE

16. 06. 17/16. 06. 27

GRADUATED FROM

Nikolayev Maritime School ” NMS”: 01. 09. 07/11. 04. 09 - OS - Seaman 2nd Class, Motorman 2nd Class.

Kherson Maritime College: (HMSFI) Kherson School of the fishing industry: 01. 09. 2009/25. 05. 2012 - NAVIGATOR

ENGLISH ABILITY

FLUENT q

VERY GOOD q

GOOD q

FAIR q

B. NATIONAL CERTIFICATION
CERTIFICATE	NUMBER	ISSUING - VALIDATION DATE	ISSUING PLACE
CERTIFICATE OF COMPETENCY	15958/2015/11	24. 12. 2015-24. 11. 2020	Kherson, Ukraine
ENDORSEMENT OF CERTIFICATE	13400/2015/07	26. 08. 2015-26. 05. 2020	Nikolaev, Ukraine
GMDSS (DECK OFF. )	15958/2015/11	26. 08. 2015-26. 05. 2020	Nikolaev, Ukraine
CERTIFICATE OF Proficiency (Tanker)	13297/2016/07	02. 08. 2016-29. 07. 2021	Nikolaev, Ukraine
ENDORSEMENT OF GMDSS	13400/2015/07	26. 08. 2015-26. 05. 2020	Nikolaev, Ukraine
SHIP SECURITY OFFICER		22. 06. 2016-22. 06. 2021	Nikolaev, Ukraine
BASIC SAFETY		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
PROFICIENCY IN SURV CRAFT		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
MEDICAL FIRST AID(A-VI/4-1)		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
ADVANCED MEDICAL CARE(A-VI/4-2)		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
ADVANCED FIRE FIGHTING		18. 03. 2015-18. 08. 2020	Nikolaev, Ukraine
RADAR (DECK OFF. )		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
Carrying dangerous & hazardous cargo (B-V/4, B-V/5)		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
Bridge team management II/1, II/2, VIII/2, B-1/12		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
Familiarization course on ship and port facility security for crew		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
Security-Related Training and Instruction for all Seafarers (A-VI/6-1)		15. 01. 2014-15. 01. 2019	Nikolaev, Ukraine
Designated Security Duties of Shipboard Personnel (A-VI/6-2)		15. 01. 2014-15. 01. 2019	Nikolaev, Ukraine
ECDIS JRC (Jan 901B, /701B, /2000/901M/901/701)	032/2016	12. 08. 2016	Odessa, Ukraine
ECDIS (DECK OFF. )		18. 03. 2015-18. 03. 2020	Nikolaev, Ukraine
LAST MEDICAL	CA 35-17	31. 01. 2017-03. 01. 2017	Nikolaev, Ukraine
Inert Gas System		22. 06. 2016-01. 06. 2021	Nikolaev, Ukraine
Basic training for oil and chemical tanker Cargo Operations	1633	01. 06. 2016-01. 06. 2021	Nikolaev, Ukraine
Crude Oil Washing		01. 06. 2016-01. 06. 2021	Nikolaev, Ukraine
VACCINATIONS	YELLOW FEVER: 04. 08. 2016 04. 08. 2026 CHOLERA : 04. 08. 2016 04. 08. 2026

C. FLAG CERTIFICATION
FLAG	TYPE / No. (S. BOOK/ENDORS/STICKER)	RANK	ISSUED	VALID	Based onNATIONAL ENDORSEMENT NUMBER
Liberia	ENDORS / 1037003	Appr/OFF	31. 08. 2016	24. 10. 2020	15958/2015/11
Liberia	S. BOOK / 1288140	Appr/OFF	31. 08. 2016	31. 08. 2021	AB460025

D. PREVIOUS SEA SERVICE
VESSEL	FLAG	TYPE/DWT	ENG/HP	RANK	S/ON	S/OFF	OWNERS/CREWING
M/V RM Glier	Ukraine	Passenger/82, 2	A1, 440	Cadet	02. 06. 2008	10. 07. 2008	ASA Ukrrechflot 044 490 6648
M/V Sankt Petersburg	Ukraine	Dry Cargo/1200	A1, 2x1080	OS	01. 05. 2011	01. 02. 2012	ASA Ukrrechflot 044 490 6648
M/V Norrbotten	Gibraltar	Dry-Cargo/5527	A1, A2, 1x2950	Cadet /OS	03. 06. 2012	28. 08. 2012	«Nautilus” (Ukraine, Nikolayev) 0512 500 464 Maxim Serheevich +380938176565 Tom Woerden - Owner
M/V Seeland	Gibraltar	Multipurpose Timber Carrier/7064	A1, A2,, 1x3840	Cadet/OS	01. 10. 2012	27. 03. 2013	«Nautilus” (Ukraine, Nikolayev) 0512 500 464 Maxim Serheevich +380938176565 Tom Woerden - Owner
M/V Lettland	Gibraltar	Timber Carrier General cargo/3978	A1, A2, 1x2700	OS	04. 06. 2013	08. 10. 2013	«Nautilus” (Ukraine, Nikolayev) 0512 500 464 Maxim Serheevich +380938176565 Tom Woerden - Owner
M/V Lettland	Gibraltar	Timber Carrier General cargo /3978	A1, A2, 1x2700	OS	16. 04. 2014	27. 10. 2014	«Nautilus” (Ukraine, Nikolayev) 0512 500 464 Maxim Serheevich +380938176565 Tom Woerden - Owner
M/T Yannis P.	Monrovia	Tanker Crude oil/158999	WW, 1x18678	Appr. OFF(same like Junior Off)	20. 08. 2016	28. 12. 2016	Cenmar Ukraine Llc

Version: 1/13 Seaman’s Signature: Ihnatchenko Serhey Andreevich