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APPLICATION FORM

 Name: Olena  Surname: Burduzha
 Date of birth: 15.05.1976  Place of birth: Odessa
 Permanent address: Odessa, Ukraine
 Passport (OVIR): PO 328855  Place of issue: Odessa  Date of issue: 19.03.2007  Valid until: 19.03.2017
 Seaman’s book: AB 332734  Place of issue: Odessa  Date of issue: 05.05.2005  Valid until: 05.05.2010
 Citizenship: Ukraine  Expiry date of U.S. visa: 24.02.2013
 Marital Status  Single
 Next of kin: (name, pas. No)  Chesnyakova Raya
 Supported children under age of 18  .
 (name, surname, date of birth)  .
 Knowledge of English language  Good
 Education:  Qualification:  No Diploma:  Date of Issue:
 HVTS 26   Stewardess  .  1995

Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency

00275/2004/08

Odessa

22.04.2004

---

 Endorsement STCW

00275/2004/08

Odessa

22.04.2004

13.02.2014

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

200244B

Odess

13.02.2009

13.02.2014

 Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2)

10362B

Odessa

24.03.2008

24.03.2013

 Passenger ships other than Ro-Ro (A-V/3)

03114B

Odessa

23.02.2009

23.02.2014

Sea service (during five last years):

Name of vessel

Company

DWT

Flag

Type

Position

From

To

 Hebridean Spirit   Univis

70

UK

Yacht

Stewardess

07.09.2006

13.12.2006

 Hebridean Spirit   Univis

70

UK

Yacht

Stewardess

12.04.2007

17.08.2007

 Yacht Express   Univis

.

N.Antilles

Heavy lift

Stewardess

23.03.2008

18.09.2008

 Experience at sea: Since 1995  Knowledge Personal Computer (Yes / No): No 
 Medical Certificate  ¹  Issued:  Place:  Exp.date:
 Vaccination for cholera valid until:  Vaccination for yellow fever valid until: 27.03.2018 

Ready to work from:  any time

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