Scribd Logo
Upload

Welcome to Scribd!

  • Application Form: Attach Your Photo Here

    Uploaded by

    Влад
    29 views1 page
    1. This document appears to be an application form submitted by Vladislav Horobets for a position on a ship. It contains personal details like name, date of birth, contact information, citizenship, licenses held, and details of previous sea service. 2. The form lists Horobets' identifying information such as passport number, dates of issue and expiration, as well as his education, language skills, physical description, and emergency contact. 3. Previous experience is detailed, including a prior position as a cadet aboard the "Solex" from August to August 2020, operating out of the port of Odessa, Ukraine.

    Original Description:

    Original Title

    Application-Form Horobets Vladislav

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    1. This document appears to be an application form submitted by Vladislav Horobets for a position on a ship. It contains personal details like name, date of birth, contact information, citizenship, licenses held, and details of previous sea service. 2. The form lists Horobets' identifying information such as passport number, dates of issue and expiration, as well as his education, language skills, physical description, and emergency contact. 3. Previous experience is detailed, including a prior position as a cadet aboard the "Solex" from August to August 2020, operating out of the port of Odessa, Ukraine.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    29 views1 page

    Application Form: Attach Your Photo Here

    Uploaded by

    Влад
    1. This document appears to be an application form submitted by Vladislav Horobets for a position on a ship. It contains personal details like name, date of birth, contact information, citizenship, licenses held, and details of previous sea service. 2. The form lists Horobets' identifying information such as passport number, dates of issue and expiration, as well as his education, language skills, physical description, and emergency contact. 3. Previous experience is detailed, including a prior position as a cadet aboard the "Solex" from August to August 2020, operating out of the port of Odessa, Ukraine.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 1

    Application form Attach your photo

    here
    1st 2nd

    (фотография)
    Surname: Horobets First name: Vladislav Middle name: Ruslanovich
    Permanent address: Ukraine, Odessa, str. Vice-admiral Zhukov h.7, ap. 6 E-
    mail:vladikgorobets@gmail.co
    m
    Date of birth (дата рождения) Place of birth (место Citizenship (гражданство) Min .salary (мин.з/п)
    24.09.2000 рождения) Odessa Ukraine
    Phone (mob.) +380971072051 Phone (mob.) +380667024437 Nearest Airport: Odessa
    Marital status (married/Single/Divorced): Single Number/ age of children: -
    Next of kin (name/relation): Ruslan/father Next of kin (address):
    Colors of eyes: Blue Colors of hair: Brown Special marks: -
    Height: 178 cm Weight: 64 kg Overall size:46 Shoes size: 42
    Knowledge of English (Fluent/Good/Satisfactory/Poor): Satisfactory Other languages: Ukraine, Russian
    Licenses & Certificates held Date of issue Date of expiry Place of issue (место
    (дата выдачи): (дата истечения выдачи):
    строка):
    Passport: 003996415 02.10.2019 02.10.2029 5115
    Seaman’s passport: AB675425 16.03.2021 16.03.2026 Port Odessa
    Travel passport: GA037813 23.03 2021 23.03.2031 5101
    Basic safety: №169589 20.07.2020 20.07.2025 Black sea Training
    Center
    Proficiency in survival craft & Rescue boats: №282187 19.03.2021 19.03.2026 Black sea Training
    Center Whale
    Security-Related Training and Instruction for all Seafarers: 19.03.2021 19.03.2026 Black sea Training
    №282188 Center Whale
    Details of previous sea service
    Rank Name of ship Flag Name of VSL Type of VSL Type of DWT BHP From To
    owner engine
    Cadet “Solex” UKR Hajibey Motor vessel Sulzer 27 tons 840 05.08.2 31.08.20
    Zegels 020 20
    ky
    Date: Signature (подпись) ________________

    You might also like