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APPLICATION FORM |
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| Name: Oleg | Surname: Kostenko | ||||||
| Date of birth: 31.01.1966 | Place of birth: Poltava reg. | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Phone: +38-048-7662008; mob.+38-050-9176543 | |||||||
| Passport (OVIR): EK 012380 | Place of issue: Odessa | Date of issue: 05.03.2009 | Valid until: 05.05.2019 | ||||
| Seaman’s book: AB 265277 | Place of issue: Odessa | Date of issue: 19.09.2003 | Valid until: 14.05.2013 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Nataliya Kostenko | ||||||
| Supported children under age of 18 | Svetlana Kostenko - 29.10.1990 | ||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Satisfactory | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Odessa Marine School | Seaman-motorman | 1991 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency |
01049 |
Illichivsk |
21.07.2008 |
--- |
| Endorsement STCW |
01049 |
Illichivsk |
21.07.2008 |
21.07.2013 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) |
104663B |
Odessa |
06.05.2008 |
06.05.2013 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) |
12834B |
Odessa |
06.05.2008 |
06.05.2013 |
| Cyprus Seaman's book |
CY 092469 |
Limassol |
16.02.2006 |
15.02.2016 |
Sea service (during five last years):
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Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| Isabella |
Akacia Universal Ltd |
1850 |
Moroni |
Dry cargo |
AB |
10.12.2004 |
09.09.2005 |
| Mekong Spirit |
Starlio Ship Co Ltd |
1045 |
Cyprus |
Container |
AB |
16.02.2006 |
13.09.2006 |
| Clipper Sun |
Tabala Co Ltd |
14000 |
Panama |
Bulker |
AB |
10.05.2007 |
18.07.2007 |
| CEC ACE |
K/S Difko ACE |
3838 |
Nassau |
Multipurp |
AB |
05.08.2007 |
15.02.2008 |
| Barbara |
Reederei MS Barbara GmbH |
22147 |
Nassau |
Bulk/Tank |
AB |
13.08.2008 |
15.02.2009 |
| Experience at sea: Since 1994 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ | Issued: | Place: | Exp.date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: | |||