Матрос/вахтенный матрос
Описание
APPLICATION FORM
Surname Grishchenko First name Kirill
Date of birth 14.12.1999 Gender (M / F) m
Citizenship RUSSIA Marital status single
Place of birth Arkhangelsk Children under 18y. none
Address (street, city, ZIP code, country) Russia Arkhangelsk region Primorsky district Severodvinsk Partizanskaya str 40/74
Next of Kin ( full name, relation, address & phone)
Sister , Grishchenko Anastasia Arkhangelsk region Primorsky district Severodvinsk
Partizanskaya str 40/7 4, +79214905285,
Phone : +7 953 261 -28 -15 Email: kirill.grishenco@gmail.com
Wage expected: - Skype: -
Certificate of competency and
flag endorsements (add IMO, STCW ref.) Cert ificate nr . Issuing country Date issued Validity of
endorsement
Rating forming part of a navigation
watch ARH203019518 Russia 14.09.2018
MLC 2006 Health Certificate 03.08.2021
Marine education received (name of school) Graduated (year) TYPE OF DEGREE RECEIVED
ADMIRAL S.O. MAKAROV STATE UNIVERSITY OF
MARINE AND RIVER FLEET 2019 Technical - Navigator
Clothes 48 -50 Shoes 41 Height 175 Weight 68
HAIR COLOR Light EYES COLOR
Languages spoken English (marlins %) German Russian Finnish other other
mother' tongue x
good
intermediate
basic x
SEA SERVICE LAST 5 YEARS
VESSEL’S NAME RANK V. Type GRT kW Main eng. Company EMPLOYMENT PERIOD
D/M/Y D/M/Y BGK -1559 CADET speedboat ВЧ -90384 08/07/18 05/03/2019 ANTEI AB TUG 304 1700 ЗАО «БЕЛФРАХТ» 23/10/2019 25/04/2020 SAMUR AB G/C 1839 ООО «Морские Перевозки» 19/08/2020 10/11/2020 SIVERKO AB F/V 448 ЗАО «БЕЛФРАХТ» 16/11/2020 15/02/2021 PUR -Navokov AB G/C 1866 ЗАО «БЕЛФРАХТ» 02/03/2021 21/06/2021 Borey AB TUG 312 ООО «ЭКОТЭК» 08/08/2021 28/12/ 2021 BALT.ISSLEDOVATEL AB O/SV 2503 3676 ФГБУ «МОРСПАССЛУЖБА »
Position applied for OS
Availability date 19.01.2022
Nearest airport Arkhangelsk
Seafarers’ Training, Certification
PART B
Identification documents Issuing country Document nr. Issued Valid until
SEAMAN’S BOOK 26.07.2016 MK 0286295 25.05.2017
SEAFARER’s ID Russia RUS 0534737 09 .02 .20 22 08 .02 .2022
TRAVEL PASSPORT Russia 75 3492814 26.07.2016 26.07.2026
Other FLAG STATE SBK
Other FLAG STATE SBK
USA V ISA
SCHENGEN V ISA
STCW CERTIFICATE STCW Ref. Certificate no. Issued Valid until
Basic safety training A-VI/1 - 1-4 AB №1872384 18.01.2022 18.01.202 7
Advanced Fire Fighting A-VI/3
Proficiency in Survival Craft & Rescue boat A-VI/2 -1 AB №1872479 22.10.2021 22.10.2026
Proficiency in Fast Rescue boat A-VI/2 -2
Ship Security Officer ISPS Code A-VI/5
Security Related Training A-VI/6 A-VI/6 -2 AB №1873110 20.01.2022 20.01.202 7
Security training - designated security duties A-VI/6 -2
Crowd Management training A-V/2 -1 AB №0092846 04.05.2018 04.05.2023
Safety training (direct services to passengers) A-V/2 -2
Crisis Management & Human Behavior A-V/2 -3
Passenger safety, cargo safety and hull integrity A-V/2 -4
Medical Care on board ship A-VI/4 Para 1 -6
Medical First Aid on board ship A-VI/4 Para 1 -3
GMDSS / GOC A-IV/2
Radar/ARPA /SAR Code section A II/2 AB №1282339 30.03.2019 30.03.2024
ECDIS (generic) Code section A II/1 AB №1282509 11.05.2019 11.05.2024
Bridge resource management (Manila 2010) I/11 Para 4
Engine resource management (Manila 2010) I/11 Para 4
Basic training for oil and chemical tanker A-V/1 -1-1
Advanced training for oil tanker A-V/1 -1-2
Advanced training for chemical tanker A-V/1 -1-3
Basic training for liquefied gas tanker A-V/1 -2-1
Advanced training for liquefied gas tanker A-V/1 -2-2
Dangerous Goods A-V/1 -2
Familiarization training (on board) ISM Code
Type rating (on board) HSC Code
English Language Test Certificate copy Marlins , Seagull, other
Food h ygiene course MLC
Ship´s cook certificate ILO – nr. 69 (1946. )
Radar observation and plotting A-1/12 B-1/12 AB №1390684 23.03.2019 23.03.2024
Other not listed above
Other information about you (mixed crew/Nationality, trading area, cargo, crane operation, other) - Have experience on General cargo
W here did you get informatio n about our c ompany ?
From internet x From friend From magazine Othe r
SIGNATURE:
I hereby declare that the above facts and information are true and accurate. I further consent to the holding and processing by the
owners of any vessel on which I may be assigned from time to time and the Managers for the purposes of my employment, of
per sonal data about me contained herein at a later date, including with respect to personal and pensions administration, employe e
management and as required to comply with any laws, regulations. I understand that this data will be stored in the Managers
data base for the purposes of my current or future employment arranged by the Managers. Further, I confirm that the above may
involve the transfer of my personal data within the Managers’ organization.
SIGNATURE: GRISHCHENKO
27 октября, 2016
Юрий
Город
Архангельск
Возраст
56 лет ( 1 января 1968)
27 октября, 2016
Светлана
Город
Архангельск
Возраст
35 лет ( 7 января 1989)
2 августа, 2015
Галина
Город
Архангельск
Возраст
46 лет ( 9 октября 1978)