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APPLICATION FORM |
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| 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 | ||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00058/2009/10 | Sevastopol |
06.04.2009 |
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| 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):
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N |
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. | MB-23 |
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Russia |
Tug |
Cadet Electrician |
13.10.2008 |
13.12.2008 |
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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 |
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1. |
2000 |
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| 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 | |||