APPLICATION FORM
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APPLICATION FORM |
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| Name: | Ruslana | ||||
| Surname: | Savelyeva | ||||
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Date of Birth: |
24.11.1984 | ||||
| Place of Birth: | Odessa, Ukraine | ||||
| Permanent address: | Odessa, Ukraine | ||||
| Personal code: | 3100911981 | ||||
| Citizenship: | Ukraine | ||||
| Passport No.: | AX 332317 | ||||
| Date of issue: | 15.11.2002 | ||||
| Place of issue: | Odessa, Ukraine | ||||
| Valid untill: | 15.11.2012 | ||||
| Seaman's Book No.: | AB 258842 | ||||
| Date of issue: | 25.10.2002 | ||||
| Place of issue: | Odessa, Ukraine | ||||
| Valid untill: | 24.09.2007 | ||||
| Expiry date of U.S. visa: | NO | ||||
| vaccination valid untill for cholera: | - | ||||
| vaccination valid untill for yellow fever: | 29.11.2002 | ||||
| Marital status: | Married: | Single: X | Divorced: | Widower: | |
| Next of kin: (name, pas. No) | |||||
| Supported children under age of 18 | - | ||||
| (name, surname, date of birth) | - | ||||
| Knowledge of English language: | Very good: | Good: | Satisfactory: X | Fair: | Poor: |
Licences, grades, certificates:
|
Licence held/grade, certificate |
No. |
Authority |
Country |
Date of issue |
Expiry date |
| Certificate of Competency Stewardess |
0155/2002 |
"TRAINING AND CERTIFYING |
Ukraine |
04.09.2002 |
04.09.2007 |
| Certificate A-VI / I LZ |
02877 B |
CENTRE SURVIVAL |
Ukraine |
26.11.2002 |
26.11.2007 |
| Certificate LZ V/2 Ro-Ro Pass Ships |
02992 B |
AT SEA OF ODESSA" |
Ukraine |
26.11.2002 |
22.11.2007 |
| Certificate LZ V/3 |
40528 B |
AT SEA OF ODESSA" |
Ukraine |
26.11.2002 |
26.11.2007 |
Sea service (during five last years):
|
Name of vessel |
Company |
HP/DWT |
Flag |
Type |
Position |
From |
To |
| Kareliya | Antarktica |
. |
Ukraine |
pass |
Stewardess |
03.12.2002 |
11.2003 |
| Iris |
Mano |
|
|
|
Stewardess |
19.05.2004 |
02.12.2004 |
Ready to work from: ANY TIME