About company Services of the company Fleet profile Our advantages Required documents Application form Contacts Hot vacancies  Application form ATTN: MR.ST.LERIOS VESSEL PROPOSED: FOR RANK: GOLDENPORT ODESSA PERSONAL DETAILS FORM POSITION APPLIED FOR Second choice (if any) Family Name First Name Father's Name Date and place of birth Seaman's book № Issued at(где) Issued on(когда) Valid International pass..№ Issued at Issued on Украинский паспорт № Выдан ОВД района, г. Home address Phone Number of children Marital status Wife's Name D.O.B. P.O.B. Next of kin Relation Name Family Name Address( If different) Phone Pre-sea education Name of Marine School Department (Факультет) Graduated on (Когда закончил) Certificates of Competency   № Grade Place of issue Date of issue/validity National diploma Endorsement НБЖС Others Sea service during at least five years Rank Vessel's name Vessel's type/DWT Company name Main Engine/BHP From month/year To month/year STCW-95 Certificates   № Place of issue Date of issue Personal sea survival GMDSS course R.O.P.S. course A.R.P.A. course Advanced fire-fighting course Proficiency in survival craft course Medical 1st aid / Ship's medical care Security officer Dangerous Cargoes Other TELEPHONE / ADDRESS LAST TWO COMPANIES / REASON OF DISCHARGE, REFERENCES: VALID VISAS: till: ENGLISH: READINESS: MIN SALARY I, the undersigned, confirm that all details provided on the form are correct Add photo

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