APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleg | Surname: Fidzina | ||||||
| Date of birth: 20.07.1971 | Place of birth: Odessa | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Passport (OVIR): EC 532337 | Place of issue: Odessa | Date of issue: 28.04.2006 | Valid until: 28.04.2016 | ||||
| Seaman’s book: AB 335613 | Place of issue: Odessa | Date of issue: 12.10.2005 | Valid until: 12.10.2010 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: 17.11.2009 | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Svetlana Fidzina | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Very good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Odessa State Maritime Academy | Engineer-Navigator | . | 1994 | ||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01893/2004/08 | Odessa |
08.12.2004 |
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| Endorsement STCW | 01893/2004/08 | Odessa |
09.09.2008 |
04.08.2013 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 2982/2008 | Odessa |
07.08.2008 |
07.08.2013 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 02478/2003/08 | Odessa |
31.12.2003 |
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| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 02478/2003/08 | Odessa |
10.09.2008 |
28.08.2013 |
| Radar Observation and Plotting (A-II/1,2) | 0370/2008 | Odessa |
08.08.2008 |
08.08.2013 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 0370/2008 | Odessa |
08.08.2008 |
08.08.2013 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 1012/2008 | Odessa |
08.08.2008 |
08.08.2013 |
| Advanced Fire Fighting (A-VI/3) | 1529/2008 | Odessa |
05.08.2008 |
05.08.2013 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 2143/2008 | Odessa |
04.08.2008 |
04.08.2013 |
| Ship's Medical Care (A-VI/4-2) | 0468/2008 | Odessa |
06.08.2008 |
06.08.2013 |
| Refresher and updating courses (II/1) | 481739 | Odessa |
14.08.2008 |
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| ECDIS | 0437/2008 | Odessa |
17.10.2008 |
17.10.2013 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 0617/2008 | Odessa |
08.08.2008 |
08.08.2013 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| BBC England | JSM |
10300 |
Marshall isl. |
MPC/Heavy lift |
Ch. Off |
13.04.2004 |
13.10.2004 |
| S. Partner | JSM |
10386 |
Marshall isl. |
MPC/Heavy lift |
Master |
17.02.2005 |
18.07.2005 |
| S. Pacific | JSM |
10385 |
Marshall isl. |
MPC/Heavy lift |
Master |
12.10.2005 |
01.03.2006 |
| Annemarie B | Lubeca Marine |
4800 |
Ant&Barb |
MPC |
Master |
17.05.2006 |
31.10.2006 |
| Annemarie B | Lubeca Marine |
4800 |
Ant&Barb |
MPC |
Master |
13.03.2007 |
01.08.2007 |
| Ocean Rouge | Cosco/Wallem |
18940 |
Panama |
Ro-Lo |
Master |
30.10.2007 |
03.04.2008 |
| BBC Trinidad | Beluga |
9821 |
Ant&Barb |
MPC/Heavy lift |
Master |
22.10.2008 |
11.02.2009 |
| Experience at sea: Since 1994 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 00998 | Issued: 20.10.2008 | Place: Odessa | Exp. date: 20.10.2009 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 30.10.2010 | |||