APPLICATION FORM
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APPLICATION FORM |
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| Name: Aleksey | Surname: Brovko | ||||||
| Date of birth: 16.01.1990 | Place of birth: Kherson | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): EA 717220 | Place of issue: Kherson | Date of issue: 19.02.2008 | Valid until: 19.02.2018 | ||||
| Seaman’s book: AB 361106 | Place of issue: Kherson | Date of issue: 21.05.2007 | Valid until: 21.05.2012 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | Brovko Oleg | ||||||
| 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 | 01.09.2005 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00382/2009/11 | Kherson |
20.07.2009 |
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| Endorsement STCW | 00382/2009/11 | Kherson |
20.07.2009 |
20.02.2014 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 14427/09 KH | Kherson |
06.03.2009 |
06.03.2014 |
| Advanced Fire Fighting (A-VI/3) | 6713/09 KH | Kherson |
06.03.2009 |
06.03.2014 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 10305/09 KH | Kherson |
06.03.2009 |
06.03.2014 |
| Medical First Aid (A-VI/4-1) | 5303/09 KH | Kherson |
06.03.2009 |
06.03.2014 |
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Tanker Certificates: |
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| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 21336/MPS | Kherson |
14.05.2010 |
14.05.2015 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 110/MPS | Kherson |
14.05.2010 |
14.05.2015 |
Sea service (during five last years):
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N |
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. | Neptune Okeanis | Sigal Shipping Co |
27788 |
Malta |
Ro-Ro |
Tr. El. Eng |
23.03.2008 |
27.08.2008 |
| 2. | Seagull | Capital Shipping Co |
2466 |
Ukraine |
Dry cargo |
Tr. El. Eng |
26.09.2008 |
24.12.2008 |
| 3. | Bulk Trader | World Wide Shipmanag |
11455 |
Panama |
Gen cargo |
As. El. Eng |
26.02.2009 |
27.08.2009 |
| 4. | REF-607 | Sigal Shipping Co |
1400 |
Moldova |
Reefer |
El. Eng |
08.09.2009 |
18.02.2010 |
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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. |
Wartsila |
16884 |
Wartsila |
3x1211 |
220/380/440 |
A1 |
Konsberg |
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2. |
SKL |
2466 |
6CH |
3x100 |
220/380 |
A2 |
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3. |
Sulzer |
9800 |
Sulzer |
3x750 |
220/380/440 |
A2 |
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4. |
SKL |
1200 |
6CH |
3x100 |
220/380 |
A2 |
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| Experience at sea: Since 2008 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 003153 | Issued: 09.09.2009 | Place: Kherson | Exp. date: 09.09.2010 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: | |||