APPLICATION FORM

 Name: Yuriy  Surname: Bashmakov
 Date of birth: 03.08.1984  Place of birth:Ukraine, Odessa
 Permanent address:  Odessa, Ukraine
 Passport (OVIR): AX606704  Place of issue: Odessa  Date of issue: 14.07.2003  Valid until: 14.07.13
 Seaman’s book: AB 080692   Place of issue:  Ilichevsk  Date of issue: 14.05.2002  Valid until: 14.05.07
 Citizenship: Ukrainian  Expiry date of U.S. visa: 
 Marital Status  Single
 Next of kin: (name, pas. No)  Levchuk Lida KK 131849
 Supported children under age of 18  -
 (name, surname, date of birth)  -
 Knowledge of English language  Good
 Education:  Qualification:  No Diploma:  Date of Issue:
 Odessa Maritime College of Technical Fleet  Voyage Navigator  CK 21698237  13.06.2003
 Odessa Maritime Academy  Navigator  -  in progress

Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency  02670/2003/08  Odessa

18.07.2003

--

 Endorsement STCW  02670/2003/08  Odessa

18.07.2003

26.06.2008

 Personal Sea Survival (ÁÆÑ)(A-VI/1)  LZ 50144 B  Odessa

18.06.2003

18.06.2008

 G.M.D.S.S. General Operator (A-IV/2) Certificate  01353/2003/08  Odessa

24.07.2003

--

 G.M.D.S.S. General Operator (A-IV/2) Endorsement  01353/2003/08  Odessa

24.07.2003

09.07.2008

 Radar / A-483  242 M/T  Odessa

14.03.2003

14.03.2008

 Automatic Radar Plotting Aids (ARPA) / A-482)  242 M/T  Odessa

14.03.2003

14.03.2008

 Advanced Fire Fighting (A-VI/3)  LZ 24002 B  Odessa

18.06.2003

18.06.2008

 Proficiency in Survival Craft and Rescue Boats  LZ 36922 B  Odessa

18.06.2003

18.06.2008

 Medical First Aid  LZ 22623 B  Odessa

18.06.2003

18.06.2008

 Panama Endorsement  14GO610106  Panama

27.06.2006

26.06.2008

 Panama GMDSS Endorsement  36653196  Panama

27.06.2006

09.07.2008

 Malta Endorsement  42904  Malta

17.08.2005

26.06.2008

 Ship security officer  0673/2005  Odessa

03.06.2005

03.06.2010

 Ship safety officer  0142/2006  Odessa

09.03.2006

09.03.2011

Sea Service (during five last years):

Name of vessel

Company

DWT

Flag

Type

Position

From

To

 Arabatskiy  Champ

1971

Ukraine

Dredger

Cadet

01.06.2001

30.09.2001

 Arabatskiy  Champ

1971

Ukraine

Dredger

Cadet

12.06.2002

31.08.2002

 Desna  Champ

1225

Ukraine

Dredger

3-rd Off

22.08.2003

08.12.2003

 Corali  Lamba

18000

Malta

Bulker

App/Off

18.09.2004

30.04.2005

 Corali  Lamba

18000

Malta

Bulker

3-rd Off

01.08.2005

10.01.2006

 IOS  Goldenport

70000

Panama

Bulker

3-rd Off

26.04.2006

24.12.2006

 Experience at sea:  Since 2001  Knowledge Personal Computer: Yes
 Medical Certificate:  ¹ 000062  Issued: 01.09.2004  Place: Odessa  Exp. date:
 Vaccination for cholera valid until:  Vaccination for yellow fever valid until: 01.09.2014