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APPLICATION FORM

 Name: Lyudmyla  Surname: Sopina
 Date of birth: 07.01.1966  Place of birth: Ukraine
 Permanent address: Nikolaev, Ukraine
 Passport (OVIR): EE 139497  Place of issue: Nikolaev  Date of issue: 09.06.2008  Valid until: 09.06.2018
 Seaman’s book: AB 357017  Place of issue: Nikolaev  Date of issue: 10.08.2007  Valid until: 09.08.2012
 Citizenship: Ukraine  Expiry date of U.S. visa: NO
 Marital Status  Single
 Next of kin: (name, pas. No)  
 Supported children under age of 18  
 (name, surname, date of birth)  
 Knowledge of English language  Fair
 Education:  Qualification:  Date of Issue:
 Marine Vocational School   cook  27.07.2007

Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency

00205/2007/07

Nikolaev

27.07.2007

---

 Endorsement STCW

00205/2007/07

Nikolaev

27.07.2007

11.07.2012

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

03934

Nikolaev

11.07.2007

11.07.2012

Sea service (during five last years):

Name of vessel

COMPANY

DWT

Flag

Type

Position

From

To

 Sun Bee   Sun Glory Shipping 

1500

Panama

Fishboat

cook

10.02.2007

28.06.2007

 Sun Bee   Oriental Shipping Co Ltd 

1500

Sierra Leone

Fishboat

cook

08.09.2007

28.04.2008

 Experience at sea: Since 2007  Knowledge Personal Computer (Yes / No): Yes  
 Medical Certificate  ¹  Issued:  Place:  Exp.date:
 Vaccination for cholera valid until:  Vaccination for yellow fever valid until:

Ready to work from:  any time

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