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Application Form (AB Sailor)
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Name: Sergiy |
Surname: Kosenko |
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Date of birth: 05.07.1986 |
Place of birth Skadovsk |
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Permanent address: Ukraine, Kherson reg, Skadovsk, Parigskoy.str.9/3 |
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Phone (805537)56245. (+38)0991630697 Email: |
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Pasport (OVIR) |
Place of issue: Kherson |
Date of issue: |
Valid until: |
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Seaman’s book№ AB 389409 |
Place of issue: Kherson |
Date of issue:05.09.2008 |
Valid until: 29.08.2017 |
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Marital Status: |
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Next of kin: (name, pas. No) |
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Education: |
Qualification |
No Diploma |
Date of issue |
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College: Kherson Maritime college |
AB Sailor |
№ 00424/2008/11 |
11.08.2008 |
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue: |
Expiry date |
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Basic Safaty Training |
22484/2012/42/01 |
Nikolaev |
08.08.2012 |
08.08.2017 |
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Proficiency in Survival Craft |
19852/2012/42/02 |
Nikolaev |
08.08.2012 |
08.08.2017 |
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Advanced Fire Fighting |
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Mdical First Aid |
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Dangerous & Hazardous Cargoes |
14814/2012/42/20 |
Nikolaev |
08.08.2012 |
08.08.2017 |
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Period of service |
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Form |
To |
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1 |
Tavr |
Maryn –Servis lt |
2371 |
Ukraine |
Cargo -Passenger |
AB Seaman |
18.08.08 |
15.02.2012 |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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