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APPLICATION FORM |
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| Name: Petro | Surname: Malchev | ||||||
| Date of birth: 08.10.1973 | Place of birth: Izmail | ||||||
| Permanent address: Izmail, Odessa reg., Ukraine | |||||||
| Passport (OVIR): AX 100546 | Place of issue: Izmail | Date of issue: 13.06.2002 | Valid until: 13.06.2012 | ||||
| Seaman’s book: AB 383048 | Place of issue: Izmail | Date of issue: 03.06.2009 | Valid until: 03.06.2014 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Malcheva Olesia | ||||||
| Supported children under age of 18 | 1. Malcheva Maria, 23.12.2007 | ||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Seamen's Training Centre | Motorman | 2002 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00136/2004/01 | Izmail |
15.06.2009 |
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| Endorsement STCW | 00136/2004/01 | Izmail |
15.06.2009 |
15.06.2014 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 202590 U | Izmail |
24.03.2009 |
24.03.2014 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 212407 U | Izmail |
11.06.2009 |
11.06.2014 |
Sea service (during five last years):
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Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Khudozhnik Plastov | Seanev Ltd | 3712 |
Phon |
Dry cargo |
motorman |
12.04.2004 |
08.07.2005 |
| Khudozhnik Plastov | Seanev Ltd | 3712 |
Phon |
Dry cargo |
motorman |
18.12.2005 |
18.09.2006 |
| Khudozhnil Plastov | Seanev Ltd | 3712 |
Phon |
Dry cargo |
motorman |
20.10.2006 |
18.05.2007 |
| Skif | Ritch holding Co | 3466 |
St.Vincent |
Gen cargo |
motorman |
31.08.2007 |
28.11.2007 |
| Fairplay | Brookes & Partners Ltd | 1834 |
Dominica |
Gen cargo |
motorman |
14.03.2008 |
25.07.2008 |
| Fairplay | Brookes & Partners Ltd |
1834 |
Dominica |
Gen cargo |
motorman |
15.10.2008 |
16.01.2009 |
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Experience at sea: Since 2004 |
Knowledge Personal Computer (Yes / No): No | |||
| Medical Certificate | Issued: 21.08.2009 | Place: Izmail | Exp.date: 21.08.2010 | |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 03.11.2015 | |||
Ready to work from: any time