APPLICATION FORM
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APPLICATION FORM |
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| Name: Serhiy | Surname: Sychov | ||||||
| Date of birth: 19.07.1972 | Place of birth: Russia | ||||||
| Permanent address: Kherson, Ukraine | |||||||
| Passport (OVIR): AH 843037 | Place of issue: Kherson | Date of issue: 20.02.2002 | Valid until: 20.02.2012 | ||||
| Seaman’s book: AB 418582 | Place of issue: Kherson | Date of issue: 23.02.2009 | Valid until: 23.02.2014 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Nataliya Sychova | ||||||
| Supported children under age of 18 | 1. Margarita Sychova - 10.02.1993 | ||||||
| (name, surname, date of birth) | 2. Veronika Sychova - 06.05.1996 | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Kherson Marine College | Navigator | 1992 | |||||
| Kherson State Maritime University | Navigator (Master) | 2008 | |||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00174/2007/07 | Nikolaev |
07.03.2007 |
--- |
| Endorsement STCW | 00174/2007/07 | Nikolaev |
07.03.2007 |
19.01.2012 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 19923/MPS | Kherson |
19.01.2007 |
19.01.2012 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00359/2003/09 | Sevastopol |
17.09.2003 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00359/2003/09 | Kherson |
20.02.2007 |
01.02.2012 |
| Radar Observation and Plotting (A-II/1,2) | 0425 M/T | Odessa |
26.01.2007 |
26.01.2012 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 0425 M/T | Odessa |
26.01.2007 |
26.01.2012 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 04270/MPS | Kherson |
19.01.2007 |
19.01.2012 |
| Advanced Fire Fighting (A-VI/3) | 07766/MPS | Kherson |
19.01.2007 |
19.01.2012 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 10794/MPS | Kherson |
19.01.2007 |
19.01.2012 |
| Ship's Medical CAre (A-VI/4-2) | 1389/MPS | Kherson |
19.01.2007 |
19.01.2012 |
| Ro-Ro passenger ships (A-V/2) | 0391/MPS | Kherson |
19.01.2007 |
19.01.2012 |
| Ship handling arrangements | 00328/2007/42/60 | Nikolaev |
28.02.2007 |
28.02.2012 |
| Ships Safety Officer | 003/2007 | Odessa |
29.01.2007 |
29.01.2012 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 00019/2007/04 | Odessa |
01.02.2007 |
01.02.2012 |
| HUET | A84.SG.09.0186 | Singapore |
26.11.2009 |
25.11.2013 |
| DP Basic (Induction) Course | S185/08 | Singapore |
12.06.2008 |
--- |
| DP Advanced (Simulator) Course | S328//08 | Singapore |
02.10.2008 |
--- |
| Cyprus Seaman's book | CY130060 | Limassol |
19.08.2008 |
18.08.2018 |
| Vanuatu Seaman's book | 67009 | Port Villa |
22.04.2009 |
19.01.2012 |
| Cyprus Endorsement | RE00584708 | Limassol |
19.08.2008 |
19.01.2012 |
| Vanuatu Endorsement | 09-51664 | Port Vila |
22.04.2009 |
19.01.2012 |
| Malta Endorsement | 32419 | Valletta |
25.02.2008 |
19.01.2012 |
| Belize Endorsement | 1237-09 | Belize |
24.04.2009 |
19.01.2012 |
| Singapore Endorsement | COE-D0031658 | Singapore |
18.07.2007 |
19.01.2012 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Banda Sea | LMS |
9000 |
Singapore |
Ro-Ro |
Ch. Off |
12.04.2007 |
08.09.2007 |
| Aurelia | RS Research |
1100 |
Malta |
Research |
Ch. Off |
02.11.2007 |
20.04.2008 |
| Aurelia | Rs Research |
1100 |
Malta |
Research |
Master |
20.04.2008 |
10.05.2008 |
| EDT Ares | EDT Offshore |
2650 |
Cyprus |
DSV DP2 |
Ch. Off |
19.07.2008 |
18.09.2008 |
| EDT Ares | EDT Offshore |
2650 |
Cyprus |
DSV DP2 |
Ch. Off |
10.10.2008 |
11.02.2009 |
| Gubert Tide | Tidewater Marine |
3037 |
Vanuatu |
PSV DP2 |
Ch. Off |
13.03.2009 |
21.07.2009 |
| D'Souza Tide | Tidewater Marine |
1358 |
Vanuatu |
AHTS DP1 |
Ch. Off |
27.09.2009 |
15.01.2010 |
| Experience at sea: Since 1992 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ 003757 | Issued: 19.01.2010 | Place: Kherson | Exp. date: 19.01.2011 |
| Vaccinationfor cholera valid until: | Vaccination for yellow fever valid until: 03.06.2012 | |||