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APPLICATION FORM |
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| Name: Oleksii | Surname: Reznik | ||||||
| Date of birth: 17.08.1981 | Place of birth: Dnepropetrovsk | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): PO 117746 | Place of issue: Kherson | Date of issue: 04.08.2005 | Valid until: 04.08.2015 | ||||
| Seaman’s book: AB 277738 | Place of issue: Nikolaev | Date of issue: 08.09.2005 | Valid until: 18.07.2010 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | mother - Reznik Margarita | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Odessa Marine Training Center | Steward | . | 02.06.2006 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency |
00079/2006/11 |
Kherson |
27.06.2006 |
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| Endorsement STCW |
00079/2006/11 |
Kherson |
27.06.2006 |
04.08.2010 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) |
7618/05 KH |
Kherson |
04.08.2005 |
04.08.2010 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) |
0823/2007 |
Odessa |
25.05.2007 |
25.05.2012 |
| Cyprus Seaman's book |
CY 112176 |
Limassol |
27.07.2007 |
27.07.2012 |
Sea service (during five last years):
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Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Astra | Eldorado |
11900 |
Russia |
Cargo |
Steward |
23.04.2004 |
16.05.2005 |
| Delmas Tourville | Tom worden |
22500 |
Antigua |
Container |
Messman |
11.10.2006 |
10.12.2006 |
| MSC London | Tsakos |
42800 |
Cyprus |
Container |
Steward |
27.05.2007 |
14.01.2008 |
| Experience at sea: Since 2004 | Knowledge Personal Computer (Yes / No): Yes | |||
| Medical Certificate | ¹ | Issued: | Place: | Exp.date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 28.08.2016 | |||
Ready to work from: any time