APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleksandr | Surname: Zakharenko | ||||||
| Date of birth: 03.09.1983 | Place of birth: Kherson | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): AH 843362 | Place of issue: Kherson | Date of issue: 25.02.2002 | Valid until: 25.02.2012 | ||||
| Seaman’s book: AB 328288 | Place of issue: Kherson | Date of issue: 18.11.2005 | Valid until: 18.11.2010 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: 13.04.2013 | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | . | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Kherson Maritime College | 3-rd Eng | XE 23156865 | 05.07.2003 | ||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00091/2002/07 | Nikolayev |
27.07.2002 |
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| Endorsement STCW | 00091/2002/07 | Nikolayev |
23.05.2007 |
22.03.2012 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 10543/07 KH | Kherson |
22.03.2007 |
22.03.2012 |
| Advanced Fire Fighting (A-VI/3) | 4820/07 KH | Kherson |
22.03.2007 |
22.03.2012 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 7006/07 KH | Kherson |
22.03.2007 |
22.03.2012 |
| Medical First Aid (A-VI/4-1) | 3762/07 KH | Kherson |
22.03.2007 |
22.03.2012 |
| Ship Safety Officer | 00965/04 KH | Kherson |
05.08.2004 |
05.08.2009 |
| Dutch Endorsement | 8500146687/10060899 | Netherlands |
16.07.2007 |
22.03.2012 |
| Dutch Seaman's Book | 00298774 | Netherlands |
26.06.2007 |
26.06.2017 |
| Dutch Med Certificate | 790989 | Netherlands |
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2009 |
Sea service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. S.Horshkov | Ukrrichflot | 5000 | Ukraine | cargo |
motorman |
10.09.2005 |
08.11.2005 |
| 2. P.Grabovskiy | Ukrrichflot | 3000 | Ukraine | cargo |
motorman |
21.11.2005 |
11.03.2006 |
| 3. A.Matyushenko | Ukrrichflot | 3000 | Ukraine | cargo |
3-rd Eng |
13.03.2006 |
15.04.2006 |
| 4. 10-ya pyatiletka | Ukrrichflot | 3000 | Ukraine | cargo |
3-rd Eng |
19.04.2006 |
10.07.2006 |
| 5. GreenGlacier | GreenShipping | 6800 | Valetta | reefer |
4-th Eng |
26.07.2006 |
07.03.2007 |
| 6. Inger | Wijnne&Barends | 4227 | Holland | multipurp |
3-rd Eng |
20.06.2007 |
08.10.2007 |
| 7. Irina | Wijnne&Barends | 4227 | Holand | multipurp |
3-rd Eng |
14.11.2007 |
15.01.2008 |
| 8. Kent Trader | Rederi AB Lillgard | 7580 | Holand | Gen cargo/cont |
3-rd Eng |
09.05.2008 |
17.10.2008 |
| 9. Tanja | Rederi AB Lillgard | 4500 | Holand | Gen cargo/cont |
2-nd Eng |
22.11.2008 |
27.02.2009 |
|
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. |
Russian diesel |
4 |
1800 |
Skoda |
/180 |
. |
with |
| 2. |
NVD |
4 |
1200 |
6ch12/14 |
/120 |
. |
with |
| 3. |
NVD |
4 |
1200 |
6ch12/14 |
/120 |
. |
with |
| 4. |
NVD |
4 |
1200 |
6ch12/14 |
/120 |
. |
with |
| 5. A2 |
Akasaka-mitsubishi |
2 |
5100 |
Yanmar |
/400 |
. |
with |
| 6. A1 |
Caterpillar |
4 |
3300 |
Caterpillar |
/150 |
yes |
without |
| 7. A1 |
Caterpillar |
4 |
3300 |
Catepillar |
/150 |
yes |
without |
| 8. A2 |
MAN B&W7L40/45 |
4 |
5438 |
MAN B&W9L20/27 |
/800 |
. |
with |
| 9. A1 |
Wartsila |
4 |
2395 |
Volvo-penta |
/2x400 |
. |
without |
| Experience at sea: Since 2003 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ 25029714 | Issued: 12.06.2007 | Place: Odessa | Exp.date: 12.06.2008 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 25.02.2012 | |||
Ready to work from: any time