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Job/Experience/Responsibilities description

APPLICATION FORM

  FULL NAME: Yesariev Kostiantyn
RANK: OS/Messboy
HOME ADDRESS: str.Ac.Coroleva 72/ Odessa/ Ukraine
MOBILE PHONE: 063 128 77 67
E-MAIL: iamsai70r@gmail.com
SKYPE NAME: esarev92
NATIONALITY: Ukraine
DATE OF BIRTH: 06.22.1992
PLACE OF BIRTH: Odessa/Ukraine
SPOKEN ENGLISH (0-10):

NEXT OF KIN

Full Name: Skripka Anastasiya
Address: str. Novgorodskaya 6v
Date of Birth 08.06.1992
Contact telephone numbers: 1st. 093-286-52-69 2nd.  
Email Address:  
Names of Children Sex Date of Birth
     
     
     
             

EDUCATION

School/Academy name Country From To Diploma
MCTF ONMA Ukraine    
Seafarers Training Centre Ukraine

PASSPORTS/VISA

(Please, fill up details of passports and visa, if have more add into new rows)

TITLE NUMBER ISSUED VALID PLACE OF ISSUE
Seaman's Book ab495976 05.30.2012 05.30.2017 port Nikolaev
Travel passport er298684 03.14.2014 93.14.2024 Passport centre Authority 5112
         

ANOTHER SEAMAN'S BOOKS AND LICENSES

TITLE NUMBER ISSUED VALID PLACE OF ISSUE
Record book 00649/2014/24 02.20.2014   Odessa
         

CERTIFICATES AND OTHER DOCUMENTS

(Please, fill up details of certificates, documents, tranings, tests, if have more add into new rows)

TITLE CLASS/TYPE/RESULT NUMBER ISSUED VALID PLACE OF ISSUE
COC          
Endorsement Second Class Seaman 10397/2015/07 02.23.2015   port Nikolaev
GMDSS          
Endorsement          
Radar navigation-Operation level   0046/2013 02.22.2013 02.22.2018 Odessa
A.R.P.A.          
Basic safety training   12.12.2014 12.12.2019 Odessa
Advanced fire fighting          
Medical first aid          
Medical care          
Prof. in survival craft   03.18.2014 03.18.2019 Odessa
Hazardous cargo          
Dangerous cargo Petroleum        
Liquefied Gas        
Liquid Chemicals        
Tanker Specific ADVANCED SAFETY COURSE OIL TANKER        
ADVANCED SAFETY COURSE CHEM TANKER        
ADVANCED SAFETY COURSE LPG TANKER        
Electrical & electronic          
Ship security officer   03.18.2014 03.18.2019 Odessa
Safety officer   03.18.2014 03.18.2019 Odessa
Working at Height          
H2S          
HUET          
MIST          
BOSIET (FOET)          
DP (..) Basic        
Advanced        
Full        
Maintenance        
Marlin Online Test          

MEDICAL EXAMINATION / HISTORY



  Number Issued Valid Place of issue
Medical Examination 09.23.2014 09.23.2015 Odessa
Physical Examination 09.23.2014 09.23.2015 Odessa
Yellow Fever AB495976 09.23.2014 09.23.2024 Odessa
OGUK        
Medical history (mark Bold)
Have you ever signed off a ship due to medical reasons?   NO
Have you undergone any operation in the past?   NO
Have you consulted a doctor during the last 12 months for an illness/accident?   NO
Do you have any health or disability problems now?   NO

PREVIOUS SEAGOING EXPERIENCE (last 5 years)

(Please, fill up details of sea service experience, if have more add into new rows)

NAME M/V TYPE FLAG GT/DWT ENGINE BHP/KW RANK COMPANY FROM TO
Valensiya Passanger Ukr 82p.t   15kBt cadet Solex 07.01.2010 07.21.2010
Genuya Passanger Ukr 82p.t   440kBt cadet Solex 07.14.2011 08.30.2011
Reid 8 Passanger Ukr 120p.t   720kBt OS IMTP 05.24.2012 11.24.2012
Sevastopol Passenger Ukr 126p.t   440kBt OS Arovana-Tur 10.10.2014 12.09.2014
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   

Offshore experience

(Please, fill up details of offshore experince, if have more add into new rows)

Ship name Owner Project name (Client name) / Aria of operation Project description Date from to
         
         
         
         
         
         

Dry-docking experience

(Please, fill up details of dry-docking experince, if have more add into new rows)

Ship name Owner Dry-dock place Description of dry-docking Date from to
         
         
         
         
         
         

Job/Experience/Responsibilities description

 

 

General (mark Bold)
Have you ever been the subject of a court of enquiry or involved in a maritime accident?   NO
Have you ever had a professional license suspended or revoked?   NO

(If YES, please give full details and attach a separate page if necessary)

 

WORKING GEAR

Boiler Suit Size(9 S/M/L/XL/XXL)
Safety Shoe size

Date: 2016-01-14; view: 632


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