APPLICATION FORM
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APPLICATION FORM |
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| Name: Vyacheslav | Surname: Ivlev | ||||||
| Date of birth: 24.11.1950 | Place of birth: Donetsk reg, | ||||||
| Permanent address: Mariupol, Ukraine | |||||||
| Passport (OVIR): EK 461055 | Place of issue: Mariupol | Date of issue: 02.09.2009 | Valid until: 02.09.2019 | ||||
| Seaman’s book: AB 322215 | Place of issue: Mariupol | Date of issue: 01.08.2006 | Valid until: 01.08.2011 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Ivleva Vera | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Rostov Marine College | 3-rd Engineer | . | 28.06.2001 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00168/2006/06 | Mariupol |
15.05.2006 |
--- |
| Endorsement STCW | 00168/2006/06 | Mariupol |
15.05.2006 |
05.04.2011 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 06803-AS | Mariupol |
10.04.2006 |
10.04.2011 |
| Advanced Fire Fighting (A-VI/3) | 02615-AS | Mariupol |
07.04.2006 |
07.04.2011 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 02281-AS | Mariupol |
05.04.2006 |
05.04.2011 |
| Medical First Aid (A-VI/4-1) | 01462-AS | Mariupol |
12.04.2006 |
12.04.2011 |
| Malta Endorsement | 57505 | Malta |
11.06.2007 |
05.04.2011 |
Sea service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Splendor | Marlow Navigation | 20050 | Malta | Bulker |
fitter |
11.07.2004 |
19.12.2004 |
| 2. Tropic Atlantic | Marlow Navigation | 12700 | Ant&Barb | Container |
fitter |
28.03.2005 |
28.09.2005 |
| 3. Falderntor | Marlow Navigation | 7500 | Ant&Barb | Container |
fitter |
24.12.2005 |
29.04.2006 |
| 4. Svyatoi Serafim | Azmex Maritime | 27000 | Georgia | Bulker |
4-th Eng |
20.07.2006 |
31.01.2007 |
| 5. Sea Trader | N.N.N Marine Ltd | 20080 | Malta | Bulker |
3-rd Eng |
10.05.2007 |
15.01.2008 |
| 6. Barbro | Broalam AB | 28000 | Malta | Bulker |
3-rd Eng |
25.05.2008 |
19.02.2009 |
|
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 |
Sulzer |
. |
5800 |
Yamnar |
/3x550 |
. |
. |
| 2. A1 |
Man B&W |
. |
9730 |
Yanmar |
/3x670 |
. |
. |
| 3. A1 |
Man B&W |
. |
4500 |
Mitsubishi |
/2x400 |
. |
. |
| 4. A2 |
Sulzer |
. |
9900 |
Yanmar |
/2x550 |
. |
yes |
| 5. A2 |
Mitsubishi |
. |
9200 |
Yanmar |
/2x520 |
. |
yes |
| 6. A1 |
Sulzer |
. |
9500 |
Daihatsu |
/3x650 |
. |
yes |
| Experience at sea: Since 1979 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ 1801 | Issued: 05.06.2009 | Place: Mariupol | Exp.date: 05.03.2010 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 24.07.2012 | |||
Ready to work from: any time