APPLICATION FORM
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APPLICATION FORM |
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| Name: Aleksandr | Surname: Byelyakov | ||||||
| Date of birth: 18.02.1983 | Place of birth: Norilsk | ||||||
| Permanent address: Kerch, Crimea, Ukraine | |||||||
| Passport (OVIR): AK 285308 | Place of issue: Kerch | Date of issue: 24.05.2005 | Valid until: 24.05.2015 | ||||
| Seaman’s book: AB 256707 | Place of issue: Kerch | Date of issue: 09.06.2005 | Valid until: 09.06.2010 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | Vankova Irina | ||||||
| Supported children under age of 18 | 1. Byelyakov Evgeniy, 09.04.2008 | ||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Kerch Marine Tech. University | 3-rd Engineer | 30.06.2005 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00126/2005/04 | Kerch |
21.07.2005 |
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| Endorsement STCW | 00126/2005/04 | Kerch |
21.07.2005 |
29.03.2010 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 76178 KR | Kerch |
12.04.2005 |
12.04.2010 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 2/1229/08 | Kerch |
04.03.2008 |
04.03.2013 |
| Advanced Fire Fighting (A-VI/3) | 29087 KR | Kerch |
08.04.2005 |
08.04.2010 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 51723 KR | Kerch |
29.03.2005 |
30.03.2010 |
| Medical First Aid (A-VI/4-1) | 28809 KR | Kerch |
05.04.2005 |
05.04.2010 |
| Cyprus Seaman's book | CY 124245 | Limassol |
23.04.2008 |
22.04.2018 |
| Cyprus Endorsement | RE 00408108 | Limassol |
05.06.2008 |
29.03.2010 |
Sea service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Ribalka Sevastopolya | AFK Universal Consulting | 4407 | Ukraine | F/V |
4-th Eng |
12.04.2006 |
07.11.2006 |
| 2. Gran Elpis | Taerim Corporation | 4133 | Panama | Reefer |
3-rd Eng |
05.02.2007 |
21.07.2007 |
| 3. Apollonia Star | Apollonia Lines | 7895 | Cyprus | Gen cargo |
3-rd Eng |
01.04.2008 |
14.08.2008 |
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Automation (A1/A2) |
Main Eng. Maker/Model |
Engine Stroke |
Engine Total HP |
Aux. Engine Maker/Number |
Aux. Engine H.P. / KW |
Unmanned |
Without El.Eng. |
| 1. A2 |
6×Í Russian Diesel |
4 |
2x3500 |
6×Í 18/3x24 |
200/153 |
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| 2. A2 |
B&W 5K45 |
2 |
4940 |
Yanmar S185SL/3 |
565/410 |
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| 3. A2 |
Mitsubishi 6UEC52 |
2 |
6540 |
Yanmar 6ML-HT |
325/250 |
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with |
| Experience at sea: Since 2006 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ | Issued: | Place: | Exp.date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 09.09.2015 | |||