16, Kirova Str., 73000 Kherson, Ukraine
Phone: +38 0552 498-002
Fax: + 38 0552 498-178
Mobile: +38 050 510-51-97
           +38 050 494-09-22
E-mail: trustservice@digicom.net.ua
           nikolay@digicom.net.ua

Complete the Application form, then forward it to our e-mail address and we’ll be able to offer your services to employers should a vacancy arise.

>>> Download Application form - 31 Êb
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Position:   Citizenship:
Photo
Salary:   Marital status:
Full name:   No of Children <18:
Date of birth/
Place of birth:
  Next of kin:
Relationship:
Home address:    Address:
Tel.: +38 0 Mobile: +38 0 Tel.:
E-mail: Foreign Crew Experience: Yes/ No Nationalities: Shoe size: Overall size: Hair colour:
Educational background: Height: Weight: Hair colour:
ENGLISH Excellent Very good Good Average Poor
           
DOCUMENTS: Number Date Issued Place Issued Expiry Date
Seaman’s passport:        
Foreign passport:        
USA visa:        
Cert. of Competency:         
Endorsement:        
Cert. of Competency:         
Endorsement:        
COURSE CERTIFICATES
1 BASIC SAFETY TRAINING        
2 MEDICAL FIRST AID ON BOARD SHIP/ MEDICAL CARE        
3 PROFICIENCY IN SURVIVAL CRAFT        
4 ADVANCED FIRE FIGHTING        
5 DANGEROUS AND HAZARDOUS CARGOES        
6 RADAR OBSERVER & PLOTTING/ A.R.P.A.        
7 MAINTENANCE OF ELECTRICAL AND ELECTRONIC ENGINEERING        
8 BRIDGE TEAM MANAGEMENT        
9 SHIP HANDLING ARRANGEMENTS        
10 SHIP SECURITY OFFICER        
11 SHIPS SAFETY OFFICER        
12 TANKER FAMILIARIZATION        
13 OIL TANKERS SPECIALIZED TRAINING        
14 GAS TANKERS SPECIALIZED TRAINING        
15 CHEM. TANKERS SPECIALIZED TRAINING        
16 CRUDE OIL WASHING OF OIL TANK        
17 INERT GAS SYSTEM        
PHYSICAL FITNESS
MEDICAL EXAMINATION CERTIFICATE        
YELLOW FEVER VACCINATION        
DRUG & ALCOHOL TEST        
PREVIOUS SEA SERVICE (Previous 5 years):
Vessel’s name Type of vessel Position DWT GRT Engine type/HP Flag Company /Country/ Telephone number Period From-To
               
               
               
               
               
               
Date of readiness: Date of completion: 

 

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