APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleg | Surname: Kavun | ||||||
| Date of birth: 19.05.1963 | Place of birth: Ukraine | ||||||
| Permanent address: Ilyichevsk, Odessa reg., Ukraine | |||||||
| Passport (OVIR): AT 25856 | Place of issue: Ilyichevsk | Date of issue: 07.02.2007 | Valid until: 07.02.2012 | ||||
| Seaman’s book: AB 409257 | Place of issue: Ilyichevsk | Date of issue: 25.03.2009 | Valid until: 25.03.2014 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Kavun Antonina | ||||||
| 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 Higher Engineer Marine School | Navigator | . | 02.03.1990 | ||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00067/2003/03 | Ilyichevsk |
03.2003 |
--- |
| Endorsement STCW | 00067/2003/03 | Ilyichevsk |
13.02.2006 |
20.12.2010 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 1181483/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00034/2003/03 | Ilyichevsk |
27.02.2003 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00034/2003/03 | Ilyichevsk |
23.03.2006 |
19.01.2011 |
| Radar Observation and Plotting (A-II/1,2) | 101079/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 104040/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 124720/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| Advanced Fire Fighting (A-VI/3) | 121376/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 1191151/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| Medical First Aid (A-VI/4-1) | 123056/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
| Refresher and updating corses (II/1) | 0096/2006 | Izmail |
14.02.2006 |
14.02.2011 |
| Cyprus Seaman's book | CY 068258 | Cyprus |
16.07.2004 |
16.07.2014 |
| Cyprus Endorsement | RE 00170906 | Cyprus |
17.03.2006 |
20.12.2010 |
| Liberia Endorsement | 737570 | Liberia |
06.05.2003 |
20.12.2010 |
| BTM course | LZ 01878B | Ilyichevsk |
07.02.2006 |
07.02.2011 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 1/020/07 | Ilyichevsk |
31.05.2007 |
31.05.2012 |
| Ship Safety Officer (ISM) | 163007/2005 | Ilyichevsk |
20.12.2005 |
20.12.2010 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| P&O Nedlloyd Barossa Valley | HSC |
34638 |
Cyprus |
Cont |
Ch. Off |
28.12.2004 |
08.04.2005 |
| Maersk Vienna | HSC |
21152 |
Cyprus |
Cont |
Ch. Off |
22.07.2005 |
23.11.2005 |
| Cap Maleas | HSC |
23579 |
Cyprus |
Cont |
Ch. Off |
09.04.2006 |
29.08.2006 |
| Sea Alfa | HSC |
23579 |
Cyprus |
Cont |
Ch. Off |
24.10.2006 |
26.02.2007 |
| Sea Alfa | HSC |
23579 |
Cyprus |
Cont |
Master |
16.05.2007 |
07.10.2007 |
| Sea Alfa | HSC |
23579 |
Cyprus |
Cont |
Master |
21.01.2008 |
10.06.2008 |
| Sea Beta | HSC |
23400 |
Cyprus |
Cont |
Master |
18.08.2008 |
10.11.2008 |
| Experience at sea: Since 1990 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: 10.02.2009 | Place: Odessa | Exp. date: 10.02.2011 |
| Vaccination for cholera valid until: 03.01.2012 | Vaccination for yellow fever valid until: 03.01.2012 | |||