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APPLICATION FORM |
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| Name: Oleksandr | Surname: Kravchenko | ||||||
| Date of birth: 09.08.1973 | Place of birth: Kherson | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): EC 996759 | Place of issue: Kherson | Date of issue: 14.03.2007 | Valid until: 14.03.2017 | ||||
| Seaman’s book: AB 358173 | Place of issue: Nikolaev | Date of issue: 28.05.2008 | Valid until: 27.05.2013 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | Danelyuk Ondriy | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Nikolaev Seafarers' Training Centre | Ship's cook | . | 07.04.2008 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency |
00112/2008/07 |
Nikolaev |
15.05.2008 |
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| Endorsement STCW |
00112/2008/07 |
Nikolaev |
15.05.2008 |
14.05.2013 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) |
06273/2008/42/01 |
Nikolaev |
14.05.2008 |
14.05.2013 |
Sea service (during five last years):
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Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| Sagitta | Intresco Ltd |
. |
Malta |
Dry cargo |
cook |
22.08.2008 |
15.12.2008 |
| Experience at sea: Since 2008 | Knowledge Personal Computer (Yes / No): No | |||
| Medical Certificate | ¹ MT 001367 | Issued: 18.12.2008 | Place: Kherson | Exp.date: 18.12.2009 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 13.08.2018 | |||
Ready to work from: any time