APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleksandr | Surname: Drozdov | ||||||
| Date of birth: 07.05.1981 | Place of birth: Ukraine | ||||||
| Permanent address: Kerch, Ukraine | |||||||
| Passport (OVIR): AX 439481 | Place of issue: Kerch | Date of issue: 05.09.2003 | Valid until: 05.09.2013 | ||||
| Seaman’s book: AB 325830 | Place of issue: Kerch | Date of issue: 03.10.2007 | Valid until: 03.10.2012 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: 08.01.2012 | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | Drozdova Tatiyna, AC 435678 | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Kerch Marine Technoligical Institute | 3-rd Eng | . | 10.12.2003 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00164/2004/04 | Kerch |
18.08.2004 |
--- |
| Endorsement STCW | 00164/2004/04 | Kerch |
15.04.2008 |
28.03.2013 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 20157/MPS | Odessa |
28.03.2008 |
28.03.2013 |
| Carrying Dangerous & Hazardous cargo(B-V/4, B-V/5) | 0050/2007 | Odessa |
02.02.2007 |
02.02.2012 |
| Advanced Fire Fighting (A-VI/3) | 07889/MPS | Odessa |
28.03.2008 |
28.03.2013 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 12976/MPS | Odessa |
28.03.2008 |
28.03.2013 |
| Medical First Aid (A-VI/4-1) | 05859/MPS | Odessa |
28.03.2008 |
28.03.2013 |
| Cyprus Seaman's Book | CY 107355 | Cyprus |
15.03.2007 |
14.03.2017 |
| Liberia Seaman's Book | 0867980 | Liberia |
27.01.2009 |
27.01.2014 |
| Liberia Endorsement | 838028 | Liberia |
27.01.2009 |
27.01.2014 |
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Tanker Certificates |
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| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 0389/MPS | Odessa |
28.03.2008 |
28.03.2013 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 2529/MPS | Odessa |
28.03.2008 |
28.03.2013 |
Sea service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Kadmiy | Canadian Kama Shipping | 4000 | Russia | Dry cargo |
motorman |
29.01.2004 |
29.06.2004 |
| 2. Blue Star | Novstar Shipping Ltd | 8000 | St.Vincent | Gen cargo |
oiler |
21.09.2004 |
01.02.2005 |
| 3. Arta | Artamar Ltd | 8000 | Barbados | Oil tanker |
oiler |
22.04.2005 |
28.09.2005 |
| 4. Arta | Artamar Ltd | 8000 | Barbados | Oil tanker |
3-rd Eng |
28.09.2005 |
15.04.2006 |
| 5. CMA CGM Vanille | Danaos | 41413 | Cyprus | Container |
3-rd Eng |
28.02.2007 |
06.09.2007 |
| 6. Talia | Stamco Shipmanagement | 30000 | Bahamas | Ro-Ro |
3-rd Eng |
20.04.2008 |
10.10.2008 |
| 7. Hyundai Patriot | DS Shiffahrt | 80000 | Liberia | Container |
3-rd Eng |
17.01.2009 |
19.08.2009 |
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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. A1 |
MAN |
2 |
5400 |
SKL |
545/400 |
. |
. |
| 2. A1 |
MAK |
4 |
4200 |
Volvo |
540/400 |
. |
. |
| 3. A1 |
Sulzer |
2 |
32800 |
Daihatsu |
1300/957 |
. |
. |
| 4. A1 |
MAK/453M |
4 |
4200 |
Volvo/24KMA |
265/195 |
. |
. |
| 5. A1 |
Sulzer |
2 |
32800 |
Daihatsu/6DL |
1320/970 |
. |
. |
| 6. A1 |
MAN B&W |
2 |
22000 |
Man B&W |
/3x1500 |
Yes |
No |
| 5. A1 |
Man B&W |
2 |
89600 |
Man B&W |
/4x3000 |
Yes |
No |
| Experience at sea: Since 2003 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ | Issued: | Place: | Exp.date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 23.01.2014 | |||