SEAFAR

ER'S

APPLIC

ATION

FORM

AME Oleksand

r

URNAME Shpigalsk

yy

ATE OF 21.03.199

IRTH 1

LACE OF Nikolaev

IRTH

ATIONAL CONTACT

Ukranian 806********

TY PHONE

IVIL MOBILE

not 806********

TATUS PHONE

maried

EXT OF EMAIL acdncl@r.postjobfree.com

IN

OME

DDRESS

OSITION AVAILABL

Deck

PPLIED E FROM

Cadet

OR

EVEL OF good USA VISA

NGLISH VALID

EA SERVICE RECORD FOR THE LAST 5 YEARS

RANK TYPE OF NAME OF FLAG GRT MAIN SHIPOWN SIGNED ON/ SIGNED OFF

VESSEL VESSEL ENGINE ER /

TYPE AND CREWING

POWER

Deck Tug BASHTA UKR 226 884kwt,,NIBULO 31.05.10 / 31.08.10

Cadet NSKYY N,,

Deck Passenge OM-106 UKR 152 440kwt MERiTIM 27.04.11 / 20.06.11

Cadet r vessel E

ACADEM

Y

Deck Tug BASHTA UKR 226 884kwt,,NIBULO 21.06.11 / 10.10.11

Cadet NSKYY N,,

Deck Tanker СБ-401 UKR 663 440kwt,,BIK,, 14.10.11 / 20.02.12

Cadet

Deck Dry cargo LARA SAINT 1948 1950kwt Чорномо 01.08.12 / 05.11.12

Cadet VINCENT рське

агенство

OCUME NUMBER ISSUED VALID COUNTRY

TS

ATIONAL EP28277 14.08.200 Ukraine

ASSPOR 7 7

ATIONAL AB43050 24.02.201 24.02.201 Ukraine

EAMAN’ 5 0 5

BOOK

ICENSE Ukraine

AVIGATO 02242/20 13.11.201 Ukraine

12/07 2

NDORSE 02242/20 13.11.201 31.12.201 Ukraine

ENT 12/07 2 6

AVIGATO

ASIC 20323/12 12.04.201 12.04.201 Ukraine

AFETY KH 2 7

RAINING

ROFICIE 15531/12 11.04.201 11.04.201 Ukraine

CY IN KH 2 7

URVIVAL

RAFT

DVANCE 9330/12K 06.04.201 06.04.201 Ukraine

FIRE H 2 7

IGHTING

EDICAL 7598/12K 21.03.201 21.03.201 Ukraine

IRST AID H 2 7

EDICAL

ARE

MDSS – 00192/20 22.06.201 31.12.201 Ukraine

ENERAL 12/07 2 6

PERATO

DVANCE

OIL

ANKER

ERTIFIC

TE

DVANCE

HEMICA

TANKER

ERTIFIC

TE

DVANCE

GAS

ANKER

ERTIFIC

TE

IL,

HEM.,

AS

ANKER

AMILIRIZ

TION

RPA, 2252/12K 12.04.201 12.04.201 Ukraine

ADAR H 2 7

BS

RIDGE

EAM

ANAGE

ENT

HIP’S

ANDLIN

HIP’S 07.08.201 07.08.201

ECURITY 3 8

FFICER

CDIS 1279/12K 16.03.201 16.03.201 Ukraine

H 2 7

ELLOW 28.03.201 28.03.202 Ukraine

EVER 1 1

ACCINAT

ON

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