APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleksandr | Surname: Galash | ||||||
| Date of birth: 01.07.1955 | Place of birth: Russia | ||||||
| Permanent address: Izmail, Odessa reg., Ukraine | |||||||
| Passport (OVIR): EC 502378 | Place of issue: Odessa | Date of issue: 07.04.2006 | Valid until: 07.04.2016 | ||||
| Seaman’s book: AB 348565 | Place of issue: Izmail | Date of issue: 05.07.2005 | Valid until: 05.07.2010 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Galash Nataliya | ||||||
| Supported children under age of 18 | |||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Very good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Odessa National Maritime Academy | Navigator | 1978 | |||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01809/2004/01 | Izmail |
01.09.2004 |
--- |
| Endorsement STCW | 01809/2004/01 | Izmail |
01.09.2004 |
01.06.2014 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 204206U | Izmail |
02.06.2009 |
02.06.2014 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00590/2004/01 | Izmail |
16.06.2009 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00590/2004/01 | Izmail |
16.06.2009 |
10.06.2014 |
| Radar Observation and Plotting (A-II/1,2) | 11363U | Izmail |
05.06.2009 |
05.06.2014 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 11363U | Izmail |
05.06.2009 |
05.06.2014 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 20956U | Izmail |
03.06.2009 |
03.06.2014 |
| Advanced Fire Fighting (A-VI/3) | 20835U | Izmail |
05.06.2009 |
05.06.2014 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 212378U | Izmail |
04.06.2009 |
04.06.2014 |
| Ship's Medical Care (A-VI/4-2) | 20212U | Izmail |
01.06.2009 |
01.06.2014 |
| Marshall islands Seaman's book | 0094717 | Marshall |
08.08.2006 |
07.08.2011 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| MSC Brasilia | Tsakos |
42800 |
MI |
Container |
Master |
01.08.2005 |
01.02.2006 |
| Energy 1 | Magnus Carriers Corp |
43000 |
Panama |
Container |
Master |
01.06.2006 |
01.11.2006 |
| Energy 1 | Magnus Carriers Corp |
43000 |
Panama |
Container |
Master |
01.03.2007 |
01.07.2007 |
| Red Sea | Ofer Brothers |
15915 |
Panama |
Container |
Master |
01.11.2007 |
01.04.2008 |
| Quigdao Star | Ofer Brothers |
27000 |
Panama |
Container |
Master |
01.07.2008 |
01.11.2008 |
| MSC Black sea | Ofer Shipmanagement |
44014 |
Malta |
Container |
Master |
01.01.2009 |
01.05.2009 |
| Experience at sea: Since 1978 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: 13.07.2009 | Place: Odessa | Exp. date: 13.07.2010 |
| Vaccinationfor cholera valid until: | Vaccination for yellow fever valid until: 15.05.2016 | |||