APPLICATION FORM
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APPLICATION FORM |
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| Name: Sergiy | Surname: Kiron | ||||||
| Date of birth: 19.08.1985 | Place of birth: Moldova | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Passport (OVIR): AK 155780 | Place of issue: Odessa | Date of issue: 07.06.2004 | Valid until: 07.06.2014 | ||||
| Seaman’s book: AB 373137 | Place of issue: Odessa | Date of issue: 18.09.2008 | Valid until: 18.09.2013 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: 16.10.2012 | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | Kiron Tatyana | ||||||
| Supported children under age of 18 | |||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Very good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Odessa Maritime College | 3-rd Engineer | 01.09.2002 | |||||
| Kiev Maritime Academy | Bachelor | 01.09.2006 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00782/2006 | Odessa |
18.07.2006 |
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| Endorsement STCW | 00782/2006 | Odessa |
18.07.2006 |
07.07.2011 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 83170/2006 | Odessa |
18.01.2006 |
18.01.2011 |
| Advanced Fire Fighting (A-VI/3) | 40637/2006 | Odessa |
18.01.2006 |
18.01.2011 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 44787/2006 | Odessa |
18.01.2006 |
18.01.2011 |
| Medical First Aid (A-VI/4-1) | 29822/2006 | Odessa |
18.01.2006 |
18.01.2011 |
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Tanker Certificates |
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| Chemical Tanker (Familiarization, A-V/1, p.2-7) | 00207B | Odessa |
11.05.2006 |
11.05.2011 |
| LPG carrier (Familiarization, A-V/1, p.2-7) | 00207B | Odessa |
11.05.2006 |
11.05.2011 |
| Oil Tanker (Familiarization, A-V/1, p.2-7) | 00207B | Odessa |
11.05.2006 |
11.05.2011 |
| Crude oil washing | 0544/2008 | Odessa |
28.11.2008 |
28.11.2013 |
| Inert gas system | 0878/2008 | Odessa |
28.11.2008 |
28.11.2013 |
Sea service (during five last years):
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Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Sichem Maya | Tesma | 17800 | MI | Oil/Ch. Tanker |
Oiler |
17.09.2006 |
17.09.2007 |
| 2. Rebel-I | BGI | 50000 | Liberia | Oil Tanker |
4-th Eng |
26.09.2007 |
31.01.2008 |
| 3. Limi | Admibros | 17500 | Cyprus | Oil/Ch. Tanker |
3-rd Eng |
29.02.2008 |
29.07.2008 |
| 4. Nizon | Socatra | 45500 | France | Oil Tanker |
3-rd Eng |
14.12.2008 |
14.05.2009 |
| 5. High Venture | D'Amico | 51000 | Liberia | Oil Prod Tanker |
3-rd Eng |
19.12.2009 |
14.05.2010 |
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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 |
Man B&W |
2 |
7500 |
Man B&W |
1100/800 |
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| 2. A1 |
Man B&W |
2 |
12000 |
Man B&W |
1200/900 |
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| 3. A2 |
Man B&W |
2 |
7750 |
Yanmar |
8500/600 |
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| 4. A1 |
Man B&W |
2 |
12000 |
Man B&W |
1200/900 |
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| 5. A1 |
Man B&W |
2 |
11000 |
Man B&W |
1080/800 |
1 year |
no |
| Experience at sea: Since 2005 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ | Issued: 25.06.2009 | Place: Odessa | Exp.date: 25.06.2010 |
| Vaccination for cholera valid until: 25.06.2014 | Vaccination for yellow fever valid until: 04.08.2014 | |||