APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleksandr | Surname: Myshkin | |||
| Date of birth: 17.12.1982 | Place of birth: Ukraine | |||
| Permanent address: Sevastopol, Ukraine | ||||
| Passport (OVIR): AT 886900 | Place of issue: Kherson | Date of issue: 30.04.2002 | Valid until: 30.04.2012 | |
| Seaman’s book: AB 390463 | Place of issue: Sevastopol | Date of issue: 01.08.2008 | Valid until: 16.07.2013 | |
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | |||
| Marital Status: | Single | |||
| Next of kin: (name, pas. No) | mother - Myshkina Olga | |||
| Supported children under age of 18 | . | |||
| (name, surname, date of birth) | . | |||
| Knowledge of English language: | Fair | |||
| Education: | Qualification: | No Diploma: | Date of Issue: | |
| Kherson Marine College | El. Engineer | XE 25331022 | 06.07.2004 | |
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01247/2003/10 | Sevastopol |
27.11.2003 |
--- |
| Endorsement STCW | 01247/2003/10 | Sevastopol |
16.11.2007 |
29.10.2012 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 1188/2007 | Sevastopol |
30.10.2007 |
30.10.2012 |
| Advanced Fire Fighting (A-VI/3) | 0480/2007 | Sevastopol |
29.10.2007 |
29.10.2012 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 0898/2007 | Sevastopol |
31.10.2007 |
31.10.2012 |
| Medical First Aid (A-VI/4-1) | 0406/2007 | Sevastopol |
31.10.2007 |
31.10.2012 |
| Ship Safety Officer | 00870/04 KH | Kherson |
04.06.2004 |
04.06.2009 |
|
Tanker Certificates: |
. |
. |
. |
. |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 0153/2007 | Sevastopol |
02.11.2007 |
02.11.2012 |
| Cargo equipment on Tankers (A-V/1, paragraph 1) | 0388/2007 | Sevastopol |
02.11.2007 |
02.11.2012 |
Sea service (during five last years):
|
N |
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. | Poti | UDSC |
450 |
Ukraine |
tug |
El.Engineer |
18.07.2004 |
05.04.2005 |
| 2. | Vladimir Gusak | UDSC |
500 |
Ukraine |
tug |
El.Engineer |
08.06.2005 |
19.11.2005 |
| 3. | Sofia | UDSC |
500 |
Ukraine |
tug |
El.Engineer |
01.03.2006 |
20.06.2006 |
| 4. | Vladimir Gusak | UDSC |
500 |
Ukraine |
tug |
El.Engineer |
11.12.2006 |
18.06.2007 |
| 5. | Pusan Reefer | Laskaridis Ship. Co. |
8060 |
Liberia |
Refrigerator |
El.Engineer |
27.07.2007 |
16.10.2007 |
| 6. | Izborsk | Scotbridge Shipping Co |
2500 |
Belize |
Gen cargo |
El.Engineer |
27.12.2007 |
22.06.2008 |
| 7. | Goyen | Falor Group Ltd |
5500 |
St.Vincent |
Refrigerator |
El.Engineer |
26.10.2008 |
18.06.2009 |
|
N |
Main Eng. Maker/Model |
Engine Total HP |
Aux.Engine Maker/Number,s |
Aux. Engine H.P. / KW |
Voltage (220/380/440) |
Automation class (A1/A2) |
Automation System Maker |
Crane/Maker/ Type/SWL |
Derrick/Maker/ Type/SWL |
|
1. |
MWM |
1050 |
MWM |
2x40kw |
380 |
A2 |
. |
No |
No |
|
2. |
SKL |
2000 |
SKL |
2x70kw |
220 |
A2 |
. |
No |
No |
|
3. |
SKL |
2000 |
SKL |
2x70kw |
220 |
A2 |
. |
No |
No |
|
4. |
SKL |
2000 |
SKL |
2x70kw |
220 |
A2 |
. |
No |
No |
|
5. |
B&W |
9000 |
Yanmar |
3x680kw |
440 |
A2 |
. |
No |
Yes |
|
6. |
SKL |
1280 |
. |
3x50kw |
380 |
A2 |
Stromberg |
No |
No |
|
7. |
Mak |
5707 |
Mak |
1000kw |
380 |
A1 |
- |
Yes |
No |
| Experience at sea: Since 2004 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 3431 |
Issued: 13.08.2008 |
Place: Sevastopol | Exp. date: 13.08.2009 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 18.07.2017 | |||
Ready to work from: 08.2009