APPLICATION FORM
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APPLICATION FORM |
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| Name: Sergio | Surname: Alymov | |||
| Date of birth: 15.06.1984 | Place of birth: Kherson | |||
| Permanent address: Kherson, Ukraine | ||||
| Passport (OVIR): AT 894025 | Place of issue: Kherson | Date of issue: 29.01.2007 | Valid until: 29.01.2012 | |
| Seaman’s book: AB 324974 | Place of issue: Kherson | Date of issue: 04.09.2002 | Valid until: 04.09.2012 | |
| Citizenship: Ukraine | Expiry date of U.S. visa: 26.02.2012 | |||
| Marital Status: | Married | |||
| Next of kin: (name, pas. No) | ||||
| Supported children under age of 18 | ||||
| (name, surname, date of birth) | ||||
| Knowledge of English language: | Good | |||
| Education: | Qualification: | Date of Issue: | ||
| Kherson Maritime College | El. Engineer | 04.07.2003 | ||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00816/2003/07 | Nikolayev |
04.07.2003 |
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| Endorsement STCW | 00816/2003/07 | Nikolayev |
19.03.2008 |
19.03.2013 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 04586/2008/42/02 | Nikolayev |
19.03.2008 |
19.03.2013 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 03106/2008/42/20 | Nikolayev |
19.03.2008 |
19.03.2013 |
| Advanced Fire Fighting (A-VI/3) | 02612/2008/42/04 | Nikolayev |
19.03.2008 |
19.03.2013 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 04586/2008/42/02 | Nikolayev |
19.03.2008 |
19.03.2013 |
| Medical First Aid (A-VI/4-1) | 01739/2008/42/05 | Nikolayev |
19.03.2008 |
19.03.2013 |
| Antigua Seaman's book | 85646 | Antigua |
22.10.2008 |
22.10.2013 |
Sea service (during five last years):
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N |
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. | APL Holland | Danaos |
70000 |
Singapore |
Cont |
As.El.Eng |
07.01.2004 |
14.09.2004 |
| 2. | Kapitan Glushko | UDP |
500 |
Ukraine |
Tug |
El.Eng |
20.12.2004 |
20.12.2005 |
| 3. | APL Holland | Danaos |
70000 |
Singapore |
Cont |
El.Eng |
28.03.2006 |
02.11.2006 |
| 4. | CSCL Le Havre | Danaos |
110000 |
Cyprus |
Cont |
El.Eng |
14.03.2007 |
10.05.2007 |
| 5. | APL Malaysia | NRS |
65000 |
Monrovia |
Cont |
El.Eng |
04.08.2007 |
21.12.2007 |
| 6. | Lehmann Timber | Lehmann Shipping Co |
10000 |
Gibraltar |
Cont |
El.Eng |
08.05.2008 |
22.07.2008 |
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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. |
67000 |
MAN B&W |
3x3000 |
440 |
A1 |
Norcontrol |
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| |
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2. |
2000 |
SKL |
2x100 |
380 |
A2 |
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| |
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3. |
67000 |
MAN B&W |
3x3000 |
440 |
A1 |
Norcontrol |
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| |
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4. |
93000 |
MAN B&W |
3x3700 |
440 |
A1 |
Norcontrol |
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| |
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5. |
54000 |
MAN B&W |
3x2400 |
440 |
A1 |
Geamar |
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| |
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6. |
3000 |
Pielstick |
3x300 |
440 |
A1 |
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| Experience at sea: Since 2002 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: | Place: | Exp. date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 24.12.2013 | |||