APPLICATION FORM
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Full Sergiy Filchenkov Positio Deck Cadet Req.
name: n: salary:
Nationali Ukraine Date of 22.07.19 Place of Ukraine Available: 01.08.2013
ty: birth: 94 birth:
Home Zolotuh?na 2, v.Dniprovske. Tel. Mob 380*********
adr.: Kherson's region :
Marital single Next of Filchenkov Dmytro Relation Father
status: kin: :
NOK Mob.: 095******* E-mail **********@****.** Height/Weigh 184/85 English good
: t: :
DOCUMENTS: Number Date of Issued at (place) Valid until
issue (DD/MM/YY)
(DD/MM/YY)
Seaman's Book AB500629 24.05.2012 PORT KHERSON 17.05.2017
(National)
Foreign Passport EP630111 26.12.2012 KHERSON 26.12.2022
US Visa (C1/D):
Cert. of Competency
Cert. of Endorsement
PROFECIONAL EXPERIENCE DURING LAST 5 YERS (in backwards order):
Vessel's name / Position DWT M/E type, Flag Crewing company / Period
Type BHP Owner From-To
Kilija/BC Deck 2800 970 kWt UKR PORT KHERSON 11.06.2012
Cadet -06.07.201
2
COURSE SERTIFICATES: Number Date of Issued at Valid until
issue (place) (DD/MM/YY)
(DD/MM/YY)
Personal safety & social resp. 20393/12KH 20.04.2012 Kherson 20.04.2017
Elementary first aid
Fire fighting & fire prevention
Medical first aid
Proficiency in survival craft 16060/12KH 28.09.2012 Kherson 28.09.2017
Advanced fire fighting
Dangerous and hazardous cargoes
Medical care (Master/ Ch.Off)
Radar observer
A.R.P.A.
Maintenance of electrical and
electronic engineering
Bridge team management
Ship handling arrangement
Ship security officer (ISPS)
Ship safety officer
Tanker familiarization
Oil tanker specialized training
Gas tanker specialized training
Chem. tanker spec. training
Crude oil washing of oil tank
Inert gas system
ECDIS
GMDSS
Engine Room team management
PHYSICAL FITNESS:
Specification Number Date of Issued at Valid until
issue (place) (DD/MM/YY)
(DD/MM/YY)
Medical examination certificate 017530 13.06.2013 MCCPH 13.06.2014
Yellow fever vaccination 05.04.2013 KIherson 05.04.2023
Drug & alcohol test
Date 9 september