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APPLICATION FORM

 Name: Hennadiy  Surname: Lyulka
 Date of birth: 26.08.1952  Place of birth: Simferopol
 Permanent address: Sevastopol, Ukraine
 Passport (OVIR): EA 829977   Place of issue: Sevastopol  Date of issue: 28.03.2008  Valid until: 28.03.2018
 Seaman’s book: AB 389643  Place of issue: Sevastopol  Date of issue: 27.03.2008  Valid until: 27.02.2013
 Citizenship: Ukraine  Expiry date of U.S. visa: NO
 Marital Status  Married
 Next of kin: (name, pas. No)  wife - Suslova Olga, AP 274884
 Supported children under age of 18  .
 (name, surname, date of birth)  .
 Knowledge of English language  Good
 Education:  Qualification:  No Diploma:  Date of Issue:
 SDI Sevastopol   Shipbuilding Engineer  .  1974
 SNTU Sevastopol   Refrigerating Engineer  .  2000

 Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency  00028/2008/10  Sevastopol

12.03.2008

---

 Endorsement STCW  00028/2008/10  Sevastopol

12.03.2008

01.09.2011

 Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1)  10486 C  Sevastopol

01.09.2006

01.09.2011

 Advanced Fire Fighting (A-VI/3)  04100 C  Sevastopol

01.09.2006

01.09.2011

 Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2)  05067 C  Sevastopol

01.09.2006

01.09.2011

 Medical First Aid (A-VI/4-1)  02713 C  Sevastopol

01.09.2006

01.09.2011

 Certificate of electrogaswelder   116/2002  Sevastopol

14.06.2002

---

 Panama Seaman's Book   489490 PG  Panama

05.07.2007

05.07.2012

 Liberia Seaman's Book   0767085  Virginia

03.01.2007

03.01.2012

Sea service (during five last years):

Name of vessel

Company

DWT

Flag

Type

Position

From

To

 1. Spring Dragon  Roswell Nav. Corp   12780  St.Vincent  Reefer

Ref. Eng

26.04.2004

27.07.2004

 2. Cristal Hope  Roswell Nav. Corp   5400  Panama  Reefer

Ref. Eng

12.10.2004

21.06.2005

 3. Barents Bay  Roswell Nav. Corp   7730  Panama  Reefer

Ref. Eng

29.10.2005

19.05.2006

 4. Barents Bay  Roswell Nav. Corp   7730  Panama  Reefer

Ref. Eng

15.11.2006

25.04.2007

 5. Bristol Bay  Roswell Nav. Corp   7730  Liberia  Reefer

Ref. Eng

14.07.2007

11.02.2008

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.

-

-

-

-

-

.

.

 2.

-

-

-

-

-

.

.

 3.

-

-

-

-

-

.

.

 4.

-

-

-

-

-

.

.

 5.

-

-

-

-

-

.

.

 Experience at sea: Since 1983  Knowledge Personal Computer (Yes / No): Yes 
 Medical Certificate  ¹ 4322  Issued: 10.04.2008  Place: Sevastopol  Exp.date: 10.04.2009
 Vaccination for cholera valid until:  Vaccination for yellow fever valid until:

Ready to work from:  any time

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