APPLICATION FORM

 Name: Aleksandr  Surname: Aleksandruk
 Date of birth: 03.07.1987  Place of birth: Ukraine
 Permanent address: Sevastopol, Ukraine
 Passport (OVIR): EA 831485  Place of issue: Sevastopol  Date of issue: 31.03.2008  Valid until: 31.03.2018
 Seaman’s book: AB 392185  Place of issue: Sevastopol  Date of issue: 04.03.2009  Valid until: 09.02.2014
 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:  Very good
 Education:  Qualification:  Date of Issue:
 Sevastopol National Technical University  El. Engineer  2011

Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency  00058/2009/10  Sevastopol

06.04.2009

---

 Endorsement STCW  00058/2009/10  Sevastopol

06.04.2009

05.12.2013

 Personal Sea Survival (ÁÆÑ)(A-VI/1)  113221C  Sevastopol

05.12.2008

06.12.2013

 Advanced Fire Fighting (A-VI/3)  113221C  Sevastopol

05.12.2008

06.12.2013

 Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2)  113221C  Sevastopol

05.12.2008

06.12.2013

Sea service (during five last years):

N

Name of vessel

COMPANY

DWT

Flag

Type

Position

From

To

 1.  MB-23  

 

Russia

Tug

Cadet Electrician

13.10.2008

13.12.2008

N

Main Eng. Maker/Model

Engine Total HP

Aux.Engine Maker/Number,s

Aux. Engine H.P. / KW

Voltage (220/380/440)

Automation class (A1/A2)

Automation System Maker

Crane/Maker/ Type/SWL

Derrick/Maker/ Type/SWL

 1.

 

2000

 

 

 

 

 

 

 

 Experience at sea:  Since 2008   Knowledge Personal Computer: Yes
 Medical Certificate:  ¹ 18929  Issued: 03.02.2009  Place: Sevastopol  Exp. date: 04.02.2010
 Vaccination for cholera valid until:  Vaccination for yellow fever valid until: 25.08.2019