Старший помощник капитана

Описание

SEAMAN’S EMPLOYMENT APPLICATION FORM

Position applied for: Chief Mate Second choice (if any): 2^nd off.
Available from: 17.04.2024
Family name: Grebebnnikov First name: Dmitrii

Personal particulars

Date of birth:
11.01.1973 Place of birth: USSR, Ukraine Nationality: russian
Marital status: married Color of hair: light Color of eyes: brown
Height (cm): 178 Weight (kg): 95 Size: XL Shoes: 43
Name of father:_____________ Name of mother:_____________ Name
of spouse:_______
Children under 18 (name/date of birth):
____Elizabeth
Grebennikov__/03.08.2014_______________________________________________
_________________
Home address: 28 Tuymenskay street, Abinsk city, Krasnodar region
,Russia
Telephones: +7(918)1515790 / +7(999)6345056
Next of Kin: Surname_Grebebnnikov_______Name:_Mary
Angelane____________ Relationship__wife________
Address/Telephones +7(996)4079081
The same
E-mail: sprut73@bk.ru

Documents and certificates

Documents No Place of issue Date of issue Valid until
Seaman’s passport MK0277311

Russia

28.02.2019 28.02.2029
Civil travel passport 758489245

Russia

16.07.2018 16.07.2028
Seamen ID

Russia

Certificates of Competency Grade No Place of issue Date of issue
Endorsement valid until
National

COW

NVS208158272 Russia 25.03.2024 25.01.2029
Denmark

COW

AMPZMCRA00002 Denmark 24.06.2020 N/A
Endorsement

Chemical tanker

NVS208156504 Russia 22.03.2024 08.02.2029
Endorsement

Oil tanker

NVS208156585 Russia 22.03.2024 02.02.2029
Singapore

COW

COE-D0167398 Singapore 29.07.2019 N/A
Name of Marine School (Academy):_ Rostov-on-Don Marine College
Graduated on technical navigator

STCW Certificates No Date of issue Valid until
GMDSS

NVS208133644 13.03.2024 13.03.2029
ARPA

3042232219 20.03.2024 20.03.2029
ROPS

3042232220 20.03.2024 20.03.2029
Advanced fire-fighting

2042229935 26.02.2024 26.02.2029
Proficiency in survival craft

2042229936 26.02.2024 26.02.2029
Medical care

1042001096 12.01.2024 12.01.2029
Medical / First aid

2042229937 26.02.2024 26.02.2029
Designated Security Duties

1042227642 29.01.2024 29.01.2029
Advanced Oil Tanker Operations

2042227936 02.02.2024 02.02.2029
Basic safety/survival at sea

1042227247 25.01.2024 25.01.2029
Advanced Chemical Tanker Operations

2042228334 08.02.2024 08.02.2029
ECDIS

3042231910 15.03.2024 15.03.2029
Transas Navi-sailor 4000

2319/82551 16.07.2015 n/a
Yellow fever

n/a 2011 n/a
Schengen visa

050245832 07/07/2022 07/07/2024

Sea Service during last five years (count backwards)

Rank Vessel’s Main engine Ship-owner/Manager From
(mm.yy) To (mm.yy)

Name Flag Type DWT Type HP

Chief Officer Iscaria

Togo

Chemical tanker 2437

MAN

EXPANSE OIL& GAS LTD

29.07.2023 27.09.2023

2nd Officer Maersk Bristol

Denmark

Oil Products Tanker 29050

B&W

Maersk Tanker

21.06.2022 30.11.2022

2nd Officer Robert Maersk

Denmark

Oil Products Tanker 34801

B&W

Maersk Tanker

04.07.2021 10.12.2021

2nd Officer Bro Dersigner

Denmark

Oil Products Tanker 14846

B&W

Maersk Tanker

18.07.2020 10.01.2021

2nd Officer Maersk Kalea

Singapore

Oil Products Tanker 38878

B&W

Maersk Tanker

07.08.2019 22.02.2020

2nd Officer Romoe Maersk

Denmark

Oil Products Tanker 34806

B&W

Maersk Tanker

07.08.2018 22.01.2019

2nd Officer Maersk Magelan Singapore Chemical tanker 51551 B&W

Maersk Tanker

07.12.2017 14.05.2018

2nd Officer Britta Maersk Denmark Chemical tanker 29015 B&W

Maersk Tanker

15.03.2017 06.09.2017

2nd Officer Britta Maersk Denmark Chemical tanker 29015 B&W

Maersk Tanker

07.07.2016 28.12.2016
Notes:

Special Remarks (to be filled by office only)

Signature _____________________________
Date 08.04.2024