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APPLICATION FORM

 Name: Liliya  Surname: Glavanchuk
 Date of birth: 26.12.1975  Place of birth: Donetsk
 Permanent address: Ugledar, Ukraine
 Passport (OVIR): KC 643155  Place of issue: Donetsk  Date of issue:  Valid until: 14.07.2009
 Seaman’s book: AB 147429  Place of issue: Odessa  Date of issue:   Valid until: 14.07.2011
 Citizenship: Ukraine  Expiry date of U.S. visa: 14.05.2008
 Marital Status  Single
 Next of kin: (name, pas. No)  Vera Glavanchuk - mother
 Supported children under age of 18  .
 (name, surname, date of birth)  .
 Knowledge of English language  Very Good
 Education:  Qualification:  No Diploma:  Date of Issue:
 Institute of linguistics. Gorlovka  Specialist. Teacher  -  17.07.1998

Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency

2371/2006

Odessa

26.10.2006

---

 Endorsement STCW

---

---

---

---

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

LZ14278B

Odessa

11.10.2006

11.10.2011

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

LZ06864B

Odessa

11.10.2006

11.10.2011

 Ro-Ro Passenger ships (A-V/2)

LZ00081B

Odessa

11.10.2006

11.10.2011

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

LZ01234B

Odessa

11.10.2006

11.10.2011

Sea service (during five last years):

Name of vessel

Company

DWT

Flag

Type

Position

From

To

 1. Astor  QSC

---

Panama

Pass

Bar waiter

10.2006

03.2007

 2. Conquest  Carnival

---

Panama

Pass

hskp.

10.2005

06.2006

 3. Conquest  Carnival

---

Panama

Pass

hskp.

01.2005

09.2005

 4. Exctasy  Carnival

---

Panama

Pass

hskp.

03.2004

11.2004

 5. Regal Empress  Imp. Majesty 

---

Bahamas

Pass

Hostess

06.2003

01.2004

 6. Topas  TMP

---

Bahamas

Pass

Reception

03.2002

08.2002

 Experience at sea: Since 2002  Knowledge Personal Computer (Yes / No):
 Medical Certificate  ¹  Issued:  Place: Odessa  Exp.date: 2008
 Vaccination for cholera valid until: 11.2011  Vaccination for yellow fever valid until: 11.2011

Ready to work from:  any time

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