APPLICATION FORM
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APPLICATION FORM |
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| Name: Albert | Surname: Kostenko | ||||||
| Date of birth: 07.04..1975 | Place of birth: Mariupol | ||||||
| Permanent address: Mariupol, Ukraine | |||||||
| Passport (OVIR): AM 717244 | Place of issue: Mariupol | Date of issue: 18.09.2000 | Valid until: 18.09.2010 | ||||
| Seaman’s book: AB 387137 | Place of issue: Mariupol | Date of issue: 28.08.2008 | Valid until: 28.08.2013 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife | ||||||
| Supported children under age of 18 | . | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Odessa State Maritime Academy | Engineer-Navigator | CK 10674700 | 1999 | ||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01414/2007/07 | Nikolaev |
03.09.2007 |
--- |
| Endorsement STCW | 01414/2007/07 | Nikolaev |
03.09.2007 |
06.06.2012 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 10286-AS | Mariupol |
06.06.2007 |
06.06.2012 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00492/2003/06 | Mariupol |
22.09.2003 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00492/2003/06 | Nikolaev |
03.09.2007 |
23.08.2012 |
| Radar Observation and Plotting (A-II/1,2) | 0155-AS | Mariupol |
03.08.2007 |
03.08.2012 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 0155-AS | Mariupol |
03.08.2007 |
03.08.2012 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 03136-AS | Mariupol |
15.06.2007 |
15.06.2012 |
| Advanced Fire Fighting (A-VI/3) | 04366-AS | Mariupol |
13.06.2007 |
13.06.2012 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 06759-AS | Mariupol |
08.06.2007 |
08.06.2012 |
| Ship's Medical Care (A-VI/4-2) | 0858-AS | Mariupol |
22.06.2007 |
22.06.2012 |
| Ship's Handling Arragements | 0722-AS | Mariupol |
25.07.2007 |
25.07.2012 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 000051/2005/03 | Mariupol |
24.01.2005 |
24.01.2010 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Pride | Delta Shipping |
26131 |
Cyprus |
Bulkcarrier |
2-nd Off |
11.02.2004 |
23.05.2004 |
| Pride | Delta Shipping |
26131 |
Cyprus |
Bulkcarrier |
Ch. Off |
24.05.2004 |
08.12.2004 |
| Makeevka | CFD |
28160 |
Ukraine |
Bulkcarrier |
Ch. Off |
26.05.2005 |
15.02.2006 |
| Dobrush | CFD |
28136 |
Ukraine |
Bulkcarrier |
Ch. Off |
05.07.2006 |
31.05.2007 |
| Enterprise | Petrofin |
45572 |
Bahamas |
Bulkcarrier |
Ch. Off |
07.12.2007 |
04.07.2008 |
| Olympias | Petrofin |
53817 |
Bahamas |
Bulkcarrier |
Ch. Off |
28.11.2008 |
16.05.2009 |
| Experience at sea: Since 1999 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: | Place: | Exp. date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 20.04.2014 | |||