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APPLICATION FORM |
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| Name: Oleg | Surname: Andriyanov | |||
| Date of birth: 16.09.1957 | Place of birth: Odessa reg. | |||
| Permanent address: Odessa, Ukraine | ||||
| Passport (OVIR): AM 636630 | Place of issue: Odessa | Date of issue: 18.11.1998 | Valid until: 18.11.2008 | |
| Seaman’s book: AB 190338 | Place of issue: Odessa | Date of issue: 18.10.2000 | Valid until: 07.06.2010 | |
| Citizenship: Ukraine | Expiry date of U.S. visa: 02.05.2011 | |||
| Marital Status: | Married | |||
| Next of kin: (name, pas. No) | wife - Andriyanova Elena | |||
| Supported children under age of 18 | ||||
| (name, surname, date of birth) | ||||
| Knowledge of English language: | Good | |||
| Education: | Qualification: | Date of Issue: | ||
| Marine Engineering College: | Electrician-Technician | 1979/1991 | ||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01277/2003/03 | Odessa |
08.12.2003 |
--- |
| Endorsement STCW | 01277/2003/03 | Odessa |
10.07.2008 |
19.05.2013 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 104855B | Odessa |
19.05.2008 |
19.05.2013 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 55037B | Odessa |
26.04.2005 |
26.04.2010 |
Sea service (during five last years):
|
N |
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. | Maersk Valparaiso | Alpha Ship |
21199 |
N.Antilles |
Container |
Ass.El.Engineer |
27.01.2004 |
25.07.2004 |
| 2. | Maersk Hong Kong | Alpha Ship |
23722 |
N.Antilles |
Container |
Ass.El.Engineer |
20.10.2004 |
19.04.2005 |
| 3. | Maersk Valparaiso | Alpha Ship |
21199 |
N.Antilles |
Container |
Ass.El.Engineer |
20.07.2005 |
20.01.2006 |
| 4. | CSAV Montreal | Oskar Wehrkg |
21211 |
Marshall isl |
Container |
Ref.Technician |
08.05.2006 |
20.10.2006 |
| 5. | CSAV Montreal | Oskar Wehrkg |
21211 |
Marshall isl |
Container |
Ref.Technician |
14.02.2007 |
22.06.2007 |
| 6. | CSAV Rio Baker | Oskar Wehrkg |
31198 |
Marshall isl |
Container |
Ref.Technician |
15.11.2007 |
03.05.2008 |
| 7. | CSAV Rio Baker | Oskar Wehrkg |
31198 |
Marshall isl |
Container |
Ref.Technician |
15.10.2008 |
10.01.2009 |
| Experience at sea: Since 2003 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 5.163 | Issued: 25.03.2008 | Place: Odessa | Exp. date: 05.03.2009 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: | |||