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APPLICATION FORM |
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| 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 | ||||
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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 | |||