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APPLICATION FORM |
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| Name: Andriy | Surname: Kryvosheyev | ||||||
| Date of birth: 23.09.1979 | Place of birth: Crimea | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): PO 145292 | Place of issue: Crimea | Date of issue: 18.10.2006 | Valid until: 18.10.2016 | ||||
| Seaman’s book: AB 362032 | Place of issue: Kherson | Date of issue: 26.07.2007 | Valid until: 26.07.2012 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Lytvyniuk Irina | ||||||
| Supported children under age of 18 | 1. Kryvosheyeva Evgenia - 02.12.2000 | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Vocational School | cook | 1767 | 23.01.2001 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency |
00112/2005/09 |
Sevastopol |
18.11.2005 |
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| Endorsement STCW |
00112/2005/09 |
Sevastopol |
18.11.2005 |
21.04.2009 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) |
1544/2007 |
Odessa |
31.07.2007 |
31.07.2012 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) |
1290/2007 |
Odessa |
24.07.2007 |
24.07.2012 |
Sea service (during five last years):
|
Name of vessel |
COMPANY |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Izberbash | Dergzava shipping |
. |
Russia |
Refrigirator |
cook |
09.07.2002 |
20.05.2003 |
| 2. Svesa | Ribflot |
. |
Ukraine |
Refrigirator |
cook |
14.07.2004 |
16.04.2005 |
| 3. Slavutich | Sea Sped Ltd |
. |
Russia |
Gen cargo |
cook |
19.04.2005 |
20.09.2005 |
| 4. Danapris-2 | Capital shipping Co |
. |
Ukraine |
Gen cargo |
cook |
23.12.2005 |
23.08.2006 |
| 5. Nautic | Rokoshipmanagement |
. |
Bahamas |
Refrigirator |
cook |
23.11.2006 |
08.07.2007 |
| Experience at sea: Since 2001 | Knowledge Personal Computer (Yes / No): yes | |||
| Medical Certificate | ¹ | Issued: | Place: | Exp.date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 22.11.2016 | |||
Ready to work from: any time