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APPLICATION FORM

 Name: Denis  Surname: Ponomarenko
 Date of birth: 29.08.1987  Place of birth: Nikolaev
 Permanent address: Nikolaev, Ukraine
 Passport (OVIR): EA 469583  Place of issue: Nikolaev  Date of issue: 03.12.2007  Valid until: 03.07.2017
 Seaman’s book: AB 357620  Place of issue: Nikolaev  Date of issue: 25.01.2008  Valid until: 26.12.2012
 Citizenship: Ukraine  Expiry date of U.S. visa: NO
 Marital Status  Single
 Next of kin: (name, pas. No)  .
 Supported children under age of 18  .
 (name, surname, date of birth)  .
 Knowledge of English language  Good
 Education:  Qualification:  No Diploma:  Date of Issue:
 College #11  Welder  .  2005
 Marine School   motorman  .  2008

 Certificates of STCW 78/95

 No.

 Place

 Date of issue

 Expiry date

 Certificate of competency  00375/2008/07  Nikolaev

27.08.2008

---

 Endorsement STCW  00375/2008/07  Nikolaev

27.08.2008

28.11.2012

 Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1)  05078/2007/42/01  Nikolaev

28.11.2007

28.11.2012

 Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2)  06187/2008/42/02  Nikolaev

17.09.2008

17.09.2013

 Tanker Certificates

.

.

.

.

 Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7)  01630/2009/42/10  Nikolaev

11.02.2009

11.02.2014

 LPG carrier (Advanced and Familiarization, A-V/1, p.2-7)  01630/2009/42/10  Nikolaev

11.02.2009

11.02.2014

 Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7)  01630/2009/42/10  Nikolaev

11.02.2009

11.02.2014

Sea service (during five last years):

Name of vessel

Company

DWT

Flag

Type

Position

From

To

 Volgo-Balt 121   Tedial-Shipping  .  Ukraine  Dry cargo

apprentice

04.02.2008

29.05.2008

 Experience at sea: Since 2008

 Knowledge Personal Computer (Yes / No):  
 Medical Certificate # 0677   Issued: 25.07.2008  Place: Nikolaev  Exp.date: 25.07.2009
 Vaccination for cholera valid until:  Vaccination for yellow fever

Ready to work from:  any time

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