APPLICATION FORM
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APPLICATION FORM |
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| Name: Dmytro | Surname: Bogdanov | ||||||
| Date of birth: 13.01.1983 | Place of birth: Sevastopol | ||||||
| Permanent address: Sevastopol, Ukraine | |||||||
| Passport (OVIR): EC 453467 | Place of issue: Sevastopol | Date of issue: 02.03.2006 | Valid until: 02.03.2016 | ||||
| Seaman’s book: AB 319160 | Place of issue: Sevastopol | Date of issue: 21.03.2006 | Valid until: 21.03.2011 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | sister - Elena Bogdanova - AP312542 | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Sankt Petrsburg Marine Institute | Navigator | 21966 | 2004 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00050/2007/10 | Sevastopol |
26.02.2007 |
--- |
| Endorsement STCW | 00050/2007/10 | Sevastopol |
31.08.2007 |
22.03.2012 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 06598C | Sevastopol |
03.08.2007 |
03.08.2012 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00196/2007/10 | Sevastopol |
26.07.2007 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00196/2007/10 | Sevastopol |
26.07.2007 |
22.03.2012 |
| Radar Observation and Plotting (A-II/1,2) | 0162C | Sevastopol |
04.08.2007 |
04.08.2012 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | . | Sevastopol |
03.08.2007 |
03.08.2012 |
| Advanced Fire Fighting (A-VI/3) | 02928C | Sevastopol |
03.08.2007 |
03.08.2012 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 04396C | Sevastopol |
03.08.2007 |
03.08.2012 |
| Medical First Aid (A-VI/4-1) | 01825C | Sevastopol |
03.08.2007 |
03.08.2012 |
| Cyprus Seaman's book | CY129073 | Cyprus |
30.07.2008 |
29.07.2018 |
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Tanker Certificates: |
. |
. |
. |
. |
| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 0898C | Sevastopol |
03.08.2007 |
03.08.2012 |
| LPG carrier (Advanced and Familiarization, A-V/1, p.2-7) | 762/07 | Sevastopol |
03.08.2007 |
03.08.2012 |
| Crude Oil Washing | 00921C | Sevastopol |
03.08.2007 |
03.08.2012 |
| Inert Gas System | 769/07 | Sevastopol |
03.08.2007 |
03.08.2012 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Drs Snayper | Russia Fleet |
1500 |
Russia |
mine-sweeper |
navigator |
03.07.2004 |
20.07.2005 |
| Gagarin | Aphrodita Shipping |
3000 |
North Korea |
Dry cargo |
AB |
21.08.2006 |
28.01.2007 |
| Lepanto 1571 | Nova Mar |
3000 |
Belize |
Dry cargo |
2-nd Off |
21.03.2007 |
13.08.2007 |
| Fortuna II | Dopmar S.R.L. |
3040 |
Panama |
Dry cargo |
2-nd Off |
01.10.2007 |
30.01.2008 |
| Sea Glory | Upton Maritime Ltd |
5000 |
Panama |
Ch. Oil Tanker |
2-nd Off |
24.03.2008 |
01.06.2008 |
| Amber I | Transmarine Manag. |
5000 |
Cyprus |
Ch. Oil Tanker |
2-nd Off |
29.06.2008 |
01.10.2008 |
| Amber I | Transmarine Manag. |
5000 |
Cyprus |
Ch. Oil Tanker |
2-nd Off |
04.11.2008 |
20.01.2009 |
| Amber I | Transmarine Manag. |
5000 |
Cyprus |
Ch. Oil Tanker |
2-nd Off |
30.03.2009 |
30.06.2009 |
| Experience at sea: Since 2005 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 12820 | Issued: 26.03.2009 | Place: Sevastopol | Exp. date: 26.03.2010 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 2015 | |||