APPLICATION FORM
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APPLICATION FORM |
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| Name: Kostyantyn | Surname: Masko | ||||||
| Date of birth: 19.09.1979 | Place of birth: Mariupol | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Passport (OVIR): EA 977087 | Place of issue: Odessa | Date of issue: 30.04.2008 | Valid until: 30.04.2018 | ||||
| Seaman’s book: AB 370196 | Place of issue: Odessa | Date of issue: 25.04.2008 | Valid until: 25.04.2013 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: 01.04.2013 | ||||||
| Marital Status | Single | ||||||
| Next of kin: (name, pas. No) | |||||||
| Supported children under age of 18 | |||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Very good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Odessa Marine Academy | Navigator | 28.03.2005 | |||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01846/2009/08 | Odessa |
09.11.2009 |
--- |
| Endorsement STCW | 01846/2009/08 | Odessa |
09.11.2009 |
29.12.2011 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 2/1541/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00053/2005/06 | Mariupol |
28.03.2005 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00053/2005/06 | Odessa |
09.11.2009 |
22.10.2014 |
| Radar Observation and Plotting (A-II/1,2) | 2/051/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 2/051/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 2/449/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Advanced Fire Fighting (A-VI/3) | 2/439/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 2/727/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Ship's Medical Care (A-VI/4-2) | 2/063/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Ro-Ro passenger ships (A-V/2) | 2/165/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Training for personnel serving on Passengers Ships | 0048/2007 | Odessa |
31.01.2007 |
31.01.2012 |
| Exploitation of ECDIS | 0178/2008 | Odessa |
25.04.2008 |
25.04.2013 |
| Ship Safety Officer | 2/041/09 | Ilyichevsk |
29.12.2006 |
29.12.2011 |
| Bridge Team & resource Management | 0506.2006 | Odessa |
29.12.2006 |
29.12.2011 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 2/193/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
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Tanker Certificates: |
. |
. |
. |
. |
| Chemical Tanker Specialized Training | 2/088/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| LPG carrier Specialized Training | 2/055/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Oil Tanker Specialized Training | 2/126/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Tanker Familiarisation Courses | 6535 KC | Odessa |
16.03.2005 |
16.03.2010 |
| Crude Oil Washing | 2/031/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
| Inert Gas System | 2/021/09 | Ilyichevsk |
05.10.2009 |
05.10.2014 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Baltic Sun II | Interorient |
37305 |
Malta |
Oil Chem Tanker |
AB |
19.08.2005 |
03.10.2006 |
| Baltic Captain I | Interorient |
37305 |
Cyprus |
Oil Chem Tanker |
AB |
05.06.2006 |
11.05.2006 |
| Baltic Chief I | Interorient |
37305 |
Cyprus |
Oil Chem Tanker |
3-rd Off |
25.03.2007 |
27.07.2007 |
| Baltic Freedom | Interorient |
37305 |
Cyprus |
Oil Chem Tanker |
3-rd Off |
30.10.2007 |
14.03.2008 |
| Baltic Commodore | Interorient |
37305 |
Malta |
Oil Chem Tanker |
3-rd Off |
21.05.2008 |
30.10.2008 |
| Baltic Commodore I | Interorient |
37305 |
Cyprus |
Oil Chem Tanker |
2-nd Off |
05.03.2009 |
11.09.2009 |
| Baltic Sky I | Interorient |
37305 |
Malta |
Oil Chem Tanker |
2-nd Off |
07.12.2009 |
03.04.2010 |
| 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: 11.11.2019 | |||