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APPLICATION FORM |
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| Name: Sergiy | Surname: Kravchenko | ||||||
| Date of birth: 06.03.1966 | Place of birth: Kherson | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): AE 871404 | Place of issue: Kherson | Date of issue: 14.09.1999 | Valid until: 14.09.2009 | ||||
| Seaman’s book: AB 351679 | Place of issue: Kherson | Date of issue: 13.03.2006 | Valid until: 13.03.2011 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Timchenko Galina | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Kherson Prof Technical School #1 | Turner | . | 20.07.1984 | ||||
| Kherson Prof Technical School #3 | Motorman | . | 07.03.1997 | ||||
| Nikolaev Seafarer's Training Center | Welder | . | 30.11.2005 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00153/2005/03 | Illichevsk |
18.04.2005 |
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| Endorsement STCW | 00153/2005/03 | Illichivsk |
18.04.2005 |
24.03.2010 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 6612/05 KH | Kherson |
24.03.2005 |
24.03.2010 |
| Advanced Fire Fighting (A-VI/3) | 3882/05 KH | Kherson |
24.03.2005 |
24.03.2010 |
| Turner Endorsement | 00239/2005/03 | Illichivsk |
19.04.2005 |
11.04.2010 |
| Welder Endorsement | 00077/2006/07 | Nikolaev |
30.03.2006 |
24.03.2010 |
Sea service (during five last years):
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Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Power Ranger | Starline Marine |
46330 |
Douglas |
Bulk carrier |
fitter |
12.05.2005 |
06.01.2006 |
| African Cobra | Starline Marine |
26648 |
Nassau |
Bulk carrier |
fitter |
16.05.2006 |
01.05.2007 |
| Bet Prinse | Starline Marine |
163554 |
Douglas |
Bulk carrier |
fitter |
13.10.2007 |
08.07.2008 |
| Viking Star | Norbulk Sea |
7239 |
Nassau |
Refrigerator |
fitter |
02.11.2008 |
12.05.2009 |
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Experience at sea: Since 1997 |
Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | Issued: | Place: | Exp.date: | |
| Vaccination for cholera valid until: | Vaccination for yellow fever | |||
Ready to work from: 08.2009