APPLICATION FORM Rank: Engine Cadet
Surname:
Gerasimjonoks
Name:Kristers
Photo
Date of Birth:
02.06.2000
Place of Birth / City & Country:
Nationality:
Riga/Latvia
latvian
Permanent address:
Latvia Dobele Zaļā iela 36-6
Phone(home):
Height:
169
Colour of eyes:
brown
Mob. Phone:
Weight:
60
Colour of hair:
brown
e-mail:
************@*****.***
Civil Status
Married
Single
Divorced
Next of kin
Address next of kin:
Relation: mother
Latvia Dobele Zaļā iela 36-6
Name: Inita Gerasimjonoka
Number of Children:
Don’t have
Phone: +371********
Nearest airport:
Riga
POSITION: Engine cadet
WELDER: Yes No
DOCUMENTS
NUMBER
ISSUED
VALID
COUNTRY, CITY
NATIONAL PASSPORT
LV5436530
08.06.2016
07.06.2021
Latvia
NATIONAL SEAMAN’ S BOOK
0271874
12.06.2019
01.06.2021
Latvia
SECURITY TRAINING FOR SEAFARES WITH DESIGNATED SECURITY DUTIES
030/19-AV
08.03.2019
Unlimited
Latvia
PROF. IN SURVIVAL CRAFT
ADVANCED FIRE FIGHTING
MEDICAL FIRST AID
MEDICAL CARE
HEALTH CERTIFICATE
YELLOW FEVER VACCINATION
USA VISA
GMDSS
ARPA & RADAR OBS
BASIC TRAINING FOR OIL AND CHEMICAL TANKER
83-129/19
06.09.2019
Unlimited
Latvia
BASIC SAFETY TRAINING
065/19-DP
17.05.2019
17.05.2024
Latvia
SEA SERVICE:
TYPE OF
VESSEL
NAME OF
VESSEL
GRT
ENG.
TYPE
HP
FLAG
NAME OF
COMPANY
RANK
PERIOD OF SERVICE
FROM / TO
dd/mm/yy / dd/mm/yy
ENGLISH:
GOOD
SATISFACTORY
MODERATE
POOR
REFERENCES (COMPANY, TEL.):