APPLICATION FORM
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APPLICATION FORM |
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| Name: Dmytro | Surname: Yemelyanov | ||||||
| Date of birth: 28.03.1968 | Place of birth: Odessa | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Passport (OVIR): EA 103381 | Place of issue: Odessa | Date of issue: 06.08.2007 | Valid until: 06.08.2017 | ||||
| Seaman’s book: AB 364920 | Place of issue: Odessa | Date of issue: 12.07.2007 | Valid until: 12.07.2012 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Yemelyanova Natalia | ||||||
| Supported children under age of 18 | 1. Yemelyanov Sergey 13.11.1995 | ||||||
| (name, surname, date of birth) | . | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | No Diploma: | Date of Issue: | ||||
| Odessa State Maritime Academy | Engineer-Navigator | --- | 1996 | ||||
|
Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00971/2002/01 | Odessa |
02.10.2002 |
--- |
| Endorsement STCW | 00971/2002/01 | Odessa |
12.09.2007 |
12.09.2012 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 93349/2007 | Odessa |
25.07.2007 |
25.07.2012 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 01894/2002/08 | Odessa |
28.08.2007 |
27.08.2012 |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 01894/2002/08 | Odessa |
28.08.2007 |
27.08.2012 |
| Radar Observation and Plotting (A-II/1,2) | 0408/2007 | Odessa |
17.08.2007 |
17.08.2012 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 0408/2007 | Odessa |
17.08.2007 |
17.08.2012 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 1402/2007 | Odessa |
25.07.2007 |
25.07.2012 |
| Advanced Fire Fighting (A-VI/3) | 47533/2007 | Odessa |
25.07.2007 |
25.07.2012 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 53342/2007 | Odessa |
25.07.2007 |
25.07.2012 |
| Ship's Medical Care (A-VI/4-2) | 0019/2007 | Odessa |
25.07.2007 |
25.07.2012 |
| Ro-Ro passenger ships (A-V/2) | 0373/2004 | Odessa |
15.12.2004 |
15.12.2009 |
| Ship Security Officer (ISPS) A/2.1.6,A/12.1,A/12.2,B/8,B/9,B/13 | 000257/2002/04 | Odessa |
16.04.2004 |
16.04.2009 |
|
ISM Code |
1478/P |
Odessa |
11.06.2004 |
11.06.2009 |
| Ship handling Arragement | 0677 KS | Odessa |
05.09.2007 |
05.09.2012 |
| Panama seamen book | CT450157 | Panama |
20.11.2003 |
15.08.2007 |
| St. Vincent certificate | 0005497 | St. Vincent |
06.04.2005 |
15.08.2007 |
| Panama certificate | 11G0403270 | Panama |
20.11.2003 |
15.08.2007 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Iduna | Unitas Shipping |
4150 |
Antigua |
Cont |
Master |
25.11.2002 |
25.05.2003 |
| Nikhil | Arpa Shipping |
3756 |
Panama |
Heavy lift |
Master |
02.10.2003 |
18.03.2004 |
| Sondor | Khalid Faraj Shipping |
7259 |
UAE |
Ro-Ro |
Master |
01.06.2004 |
18.12.2004 |
| Kaliroi | Pilot Shipping Co |
4038 |
St. Vincent |
Ro-Ro |
Master |
28.03.2005 |
28.09.2005 |
| Kaliroi | Pilot Shipping Co |
4038 |
St. Vincent |
Ro-Ro |
Master |
03.10.2005 |
05.06.2006 |
| Kaliroi | Pilot Shipping Co |
4038 |
St. Vincent |
Ro-Ro |
Master |
10.09.2006 |
05.03.2007 |
| Experience at sea: Since 1996 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: | Place: | Exp. date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 11.01.2011 | |||