Капитан дальнего плавания

Описание

Height (Рост)
185 cm
Weight (Вес)
105 kg
Safety Shoes (Размер рабочих ботинок)
45 (Russian size)
Boilersuit (Размер рабочего костюма)
64 (Russian size)
Nearest Airport(s) (International / Domestic) (Ближайший аэропорт)
Kaliningrad, Warsaw
ADDRESS (include telephone country & area codes, advise also secondary or contact addresses if any)
Street, Nr.-Apt.
Mozhayskaya str. 16
City
Kaliningrad
Postal Code (Index)
236000
Country
Russian
Home Phone

NEXT OF KIN INFORMATION (person-older than 18 years-to contact in case of insurance beneficiary)
Surname, Name
Yakushenkova
First Name(s)
Yuliya
Citizenship
Russian
Relationship
daughter
Street, Nr.-Apt.
Marina Roskova 23/4
City
Zelenogradsk Kaliningrad reg.
Postal Code (Index)
236039
Country
Russian
Home Phone

REMARKS
Requested Rank:
master
Availability Date (Month, Year):

Pref. Vessel Type:

Minimum Required Salary:
usd
ENGLISH Language Abilities:
to Speak
xxxxxxxx
to Translate Text:
xxxxxxxx
to Write:
xxxxxxxxxx
SETS Test:
xxxxxxx
Passed on:
xxxxxxxx
Other Languages:

Name of Marine (Professional) School /College/Academy:
Kaliningrad secondary marine school (1980-1983)
PERIOD (From - To):
From:
To:
Foreign Crew Experience (specify nationalities)
German
Greek
Polish

Other Skills (specify details)
SEAFARER'S APPLICATION FORM - Page 2 of 4 - LIST OF DOCUMENTS

A. TRAVEL DOCUMENTS, SEAMAN'S BOOKS AND MEDICAL CERTIFICATES
Document Name (Description)
Document No.
Country
Issue Place
Issue Date
Exp. Date
Seafarer's Identity Document
RUS 0263004
Russia
Kaliningrad
17.09.2013
16.09.2018
Travel Passport (it's mandatory to possess it)
73 2640922
Russian
Kaliningrad
18.04.2014
18.04.2024
Seaman's Book - Antigua & Barbuda
133470
Antigua
Antigua
02.12.2013
01.12.2018
Seaman's Book - Gibraltar
Seaman's Book - Netherlands
Seaman's Book - Malta
Seaman's Book - Cyprus
Seaman's Book - Panama
Seaman's Book - Curacao Netherlands

MAC 8690
Curacao
Rotterdam
09.02.2011
09.02.2016
Visa - Schengen

Germany
Kaliningrad
17.12.14
25.12.2016
Visa - USA (specify only if valid)
Visa - Lithuanian (specify only if valid)
Visa - Polish (specify only if valid)

Medical Examination Report ( if valid)
001881
Russia
Kaliningrad
02.11.2015
02.11.2016
Drug & Alcohol Test (optional)

Kali ningrad
30.10.2015
Vaccination against Yellow Fever

Kaliningrad
05.02.2009
05.02.2019

B. CERTIFICATES OF COMPETENCY (LICENSES) & ENDORSEMENTS, FLAG STATE CERTIFICATES
License Name (Description)
License Grade
License No.
Issue Place
Issue Date
Exp.Date
National License Officers or Rating's Watchkeeping Certificate
Master,Ch.Mate, OOW navigational
1040107659
Kaliningrad
08.06.2016
08.04.2021
Functions and Level
1,2,3,7 M O
Limitations
License: Antigua & Barbuda
License: Antigua & Barbuda COC
License: Cyprus
License: Netherlands
License: Germany
License: United Kingdom
License:

National GMDSS Operator Certificate
Operator GMDSS
0038286
Kaliningrad
06.02.2002
06.04.2021
C. COURSE CERTIFICATES
Document Name (Description)
Document Number
Country
Issue Place
Issue Date
Exp. Date
Radar Observer & Plotting
0316870
Russian
Kaliningrad
08.04.2016
08.04.2021
A.R.P.A.
0146502
Russian
Kaliningrad
08.04.2016
08.04.2021
Basic Safety Training (4 components)
0434852
Russian
Kaliningrad
05.05.2016
05.05.2021
Proficiency in Survival Craft/FstRscBot
0435480
Russian
Kaliningrad
13.05.2016
13.05.2021
Advanced Fire Fighting
0435214
Russian
Kaliningrad
12.05.2016
12.05.2021
Medical First Aid
0435855
Russian
Kaliningrad
11.05.2016
11.05.2021
Medical Care
0146569
Russian
Kaliningrad
20.11.2015
20.11.2020
HazMat (USA, Code Fed.Reg. 49)
065697
Russian
Kaliningrad
02.07.2013
02.07.2018
Oil Tanker Familiarization Course
Oil Tanker Advanced Training
Chemical Tanker Familiarization
Chemical Tanker Advanced Training
Gas Tanker Familiarization
Gas Tanker Advanced Training
Crowd Crisis Management (Ro-Ro)
Bridge Team Management
Crude Oil Washing (COW)
S Inert Gas System (IGS)

Ship Security Officer/Staff
AA No 0115703
Russia
Kaliningrad
25.10.2013
25.10.2018
Operational use of electronic chart display and information systems (ECDIS)
AB N 0002282
Russia
Kaliningrad
26.12.2014
26.12.2019

SEAFARER'S APPLICATION FORM - Page 3 of 4 - SEA SERVICE (LAST 10 YEARS)
Please indicate your sea service in the last 10 years as exact as possible - required are the actual sign-on and sign-off dates accounting to the certificates. To speed up processing kindly indicate phone numbers of your previous employers. Ship sizes are to be indicated in gross tons, total engine output in kilo Watt (1 kW = 1,35 bhp) to go along with STCW limitations. Please be prepared to provide evidence for sea service that cannot be confirmed by reference check. The information provided may be passed on to our clients and to flag state administrations to allow for verification of rank experience. Please use the European date format (Date.Month.Year = DD.MM.YY).
Vessel's Name_(y.b.)
Deck Mech.(Crane)
Flag
Gross Tonnag (GRT)
M/E Power (KW)
Ship's Type
TEU/REU
M/E Maker Model/Fuel
Rank
Sign-On Date
Sing-Off Date
Employer (company to contact for reference)

Shipowner Name &
(PHONE)
Crewing Agency & (PHONE)
Baltic Meteor
Panama
1030

Ferry

Master
01.01.95
01.09.99
Baltic shipping and Traiding GmBH
Baltic Shipping and Traiding GmBH
Star Maria (1975)

Panama
2400
Dry Cargo

Master
01.01.00
16.10.00
Astra Maritime
Astra Maritime
Star Maria (1975)

Panama
2400
Dry Cargo

Master
01.03.01
11.11.01
Astra Maritime
Astra Maritime
Aurelia

Luxembourg
738
Research vessel

Master
16.08.02
10.02.03
Research shipping GmBH
Aurelia

Luxembourg
738
Research vessel

Master
26.07.03
10.09.03
Research Shipping GmBH
Forum Samoa (1979)

Panama
6861
Ro-Ro,Lo-Lo
Container

Master
01.11.03
31.03.04
Fjelise Shipping GmBH
+47 38396220
Fort Ross

St.Vinsent
3024
Ro-Ro,Lo-Lo

Heavy lift,Cont.

Master
27.02.05
29.07.05
Fort Marine OU
+372 641655
Baltic Forest

Panama
2525
Dry Cargo