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Application for Employment

Position applied for: Deck Cadet

Address: 19 Luzhskaya St, Apt. 4,

Veliky Novgorod 173018, Russia

Surname: Peshekhonov

Forenames: Victor Serveevich

Tel.: 7 952 212 29 92

Cont.Tel:79502238354

Date of Birth: 09/11/1990

Marital status: Single

No of Children: non

Place of Birth: USSR, Novgorod / город Новгород

Nationality: Russia

Date, Place issued: 14.06.11 Veliky Novgorod

Native Language: Russian

Languages spoken: English

Passport: 4911 977550

Education: Secondary

Next of Kin ( Mother ): Elena Peshekhonova

Education Body: Admiral Makarov State University of Maritime and Inland Shipping, Navigating Department, 2016 (4th course)

Address: 19 Luzhskaya St, Apt. 4,

Veliky Novgorod 173018, Russia

Tel.: 79517212459

Licenses

Grade

Number

Date Issued

Education Body

Expiry Date

Certificate of Competence

Flag St. Recognition Cert

Flag St. Recognition Cert

Flag St. Recognition Cert.

GMDSS

Endorsement of GMDSS

Radar Observ. Simulator

ARPA

Survival craft & rescue boat

{ In process }

Advanced Fire-Fighting

Carriage of D-s & Has-s sub-s

First Aid at Sea

Basic safety training

342584

03/11/11

Makarov Training Center of Admiral Makarov State Maritime Academy, St.Petersburg

03/11/16

Watchkeeping

Document

Number

Date Issued

Place Issued

Expiry Date

Seaman's Passport

Seaman's Book

MK 0108624

14/03/2012

BP St.Petersburg SPA

unlimited

Travel Passport

71 6376862

06/10/2011

ФМС 53001

06/10/2021

US Visa

Health Certificate

{ In process }

Yellow Fever

Drug and Alcohol

Schengen visa

Eyes: Green

Hair: Blond

Height: 162

Weight: 55

Shoes: 41

Overall: 44

Previous Sea Experience (for last 10 Years)

From

To

Vessel

Flag

DWT

HP

Engine

TypeOfVessel

Position

Company

Com. Tel

2012.04.24

2012.10.09

MIR

Russia

2257

2*419 kW

6AL

Trainig Sail Ship

Apprantice

Admiral Makarov State Maritime Academy,

7(812)7489687

С автоматизированной обработкой моих персональных данных указанных в анкете, их передачей (включая трансграничную) и хранением в целях трудоустройства согласен.

Подпись___________________________________________________

Дата___17.01.2014__________________________________________

Готовность в рейс___12.05.2014_______________________________

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