SEAFARER'S APPLICATION FORM
Position:
MOTORMAN
Citizenship:
Ukraine
Last name:
Tsentsov
Marital status
married
First name:
Mihail
Children:
Middle name:
Nationality:
Ukrainian
Birth date:
17.02.1988
Birth place:
Ukraine
Home address:
Odessa, Ukraine, 65069
Phone mobile:
Phone home:
Email:
******@***.***
English level:
Good
Russian level:
Fluently
Salary
Minimum: 900
Expected: 1200
Last:
$/month
Passports, Licenses & Certificates
Title
Class
Number
Place of issue
Issued
Valid
Passports & Visas
Civil passport
KM244199
Rozdilna, UKR
10.06.2004
Seaman's identification card
AB561424
Nikolaev, UKR
30.09.2015
30.09.2020
Travel passport
ES775310
Odessa, UKR
20.01.2015
20.01.2025
Diplomas & Endorsements
Certificate of Competency
second class motorman
12673/2015/07
Nikolaev, UKR
14.09.2015
Certificate of Proficiency on Basic Training for Cargo Operations on Tankers
liquefied gas tanker
12930/2015/07
Nikolaev, UKR
01.10.2015
01.10.2020
Certificate of Proficiency on Basic Training for Cargo Operations on Tankers
oil and chemical tanker
12929/2015/07
Nikolaev, UKR
01.10.2015
25.09.2020
Certificates
Safety Familiarization, Basic Training and Instruction For All Seafarers
29350
Odessa, UKR
17.03.2015
17.03.2020
Basic Training For Liquefied Gas Tanker Cargo Operations
591
Odessa, UKR
10.07.2015
10.07.2020
Basic Training For Oil And Chemical Tanker Cargo Operations
964
Odessa, UKR
10.07.2015
10.07.2020
Security Awareness Training For All Seafarers
15053
Odessa, UKR
30.06.2015
30.06.2020
Training For All Seafarers With Designated Security Duties
18317
Odessa, UKR
30.06.2015
30.06.2020
Medical Certificates
Medical Certificate
Odessa, UKR
16.06.2015
16.06.2016
Yellow Fever Vaccination
Odessa, UKR
13.01.2015
13.01.2025
Sea-going experience
Vessel’s
name
Flag
Type
Engine
Rank
From
Shipowner
Year
DWT
HP
Till
Crew Agency
1
Hadzhibey
UKR
Engine Cadet
17.04.2015
SOLEX
657
840
17.06.2015
General Physical State
Height (cm)
Weight (kg)
Shoes
Clothes
Hair color
Eye color
179
82
42
L
black
brown