Судоводитель маломерного судна

Описание

SEAFARER'S APPLICATION FORM [pic]



Position:
Master

Readiness:
10.05.2021



Citizenship:
Russia

Last name:
Kisliakov
Marital status
married

First name:
Ilia
Children:
2

Middle name:
Alekseevich
Nationality:
Russian

Birth date:
22.06.1976
Birth place:
Ukraine

Home address:
Kerch, AR of Crimea, Russia, 298324
Phone mobile:
7(978)7634600



Phone home:




Email:
turistillya@gmail.com

English level:
Good
CES 6.02:
20.02.2020





Education
Educational institution
Title
Civil passport 3914 702453 Krasnodar, RUS 19.09.2014 01.01.2100
Seaman's ID 0132317 Novorossiysk, RUS 16.11.2016 15.11.2021
Seaman's book MK 02626617 Novorossiysk, RUS 26.10.2016 Permanent
Travel passport 75 2406654 Krasnodar, RUS 12.10.2015 12.10.2025
USA Visa C1/D 1870624 Kyiv, UKR 14.03.2018 12.03.2028
Diplomas & Endorsements
Diploma II/2 NVS204685673 Novorossiysk, RUS 11.02.2021 03.11.2025
Diploma Endorsement II/2 NVS204685673 Novorossiysk, RUS 11.02.2021 03.11.2025
Certificates & Licenses
Advanced Fire Fighting (VI/3) 1570989 Astrakhan, RUS 10.11.2020 10.11.2025
Automatic Radar Plotting Aids (ARPA) 1621476 Astrakhan, RUS 20.11.2020 20.11.2025
Basic Safety Training (VI/1.1-4) 1607201 Astrakhan, RUS 03.11.2020 03.11.2025
Dangerous and Hazardous Substances (V4,V5) 00000095 Astrakhan, RUS 24.11.2017 24.11.2022
GMDSS General Operator Certificate NVS204655633 Novorossiysk, RUS 27.01.2021 03.11.2025
GMDSS General Operator Endorsement NVS204655633 Novorossiysk, RUS 27.01.2021 03.11.2025
Medical First Aid (VI/4.1) 1572608 Astrakhan, RUS 27.11.2020 27.11.2025
Proficiency in Survival Craft (VI/2) 1608892 Astrakhan, RUS 09.11.2020 09.11.2025
Radar Observation and Plotting Simulator (A-II) 1620015 Astrakhan, RUS 17.11.2020 17.11.2025
Electronic Chart Display and Information System (ECDIS) 1622916 Astrakhan, RUS 13.11.2020 13.11.2025
Security training for seafarers with designated security duties 1581531 Astrakhan, RUS 06.11.2020 06.11.2025
(Section A-VI/6, table A-VI/6-2)
Guidance For Seafarers on Anti-Piracy Preparedness and Response N/A Odessa, UKR 21.09.2011 Permnent
(Officers)
Safety awareness Training program (SATPRO) 2561/14 Odessa, UKR 12.02.2014 Permnent
Ballast Water and Sediment Management and Treatment Procedure 1889/08 Odessa, UKR 15.03.2008 Permnent
Awareness Course
Heavy Lift Cargo Handling Simulator HLC-121T/13 Kherson, UKR 18.12.2013 Permnent
ChartWorld eGlobe 49137 / 151939 HAMBURG, DEU 29.06.2016 Permnent
SAM Electrinics ECDISPILOT Platinum/Basic MULTIPILOT Platinum 5620 / 16839 HAMBURG, DEU 02.02.2014 Permnent
ChartWorld eGlobe G2 00262017 Emden, DEU 29.08.2017 Permnent
Transas Navi-sailor 4000 110419 / 384678 HAMBURG, DEU 30.03.2018 Permnent
Medical Certificates
Medical Fitness Certificate 812229 Kerch, RUS 05.12.2020 05.12.2021
Drug/Alcjhol 812230 Kerch, RUS 05.12.2020 05.12.2021
Yellow Fever Vaccination N/A Astrakhan, RUS 03.12.2015 03.12.2025


Sea-going experience

Crew Agency City Country Contact Person Phone
United Maritime Agency Co. Ltd. Moscow reg., Shchelkovo, Russia. Shchelkovo Russia Yuliya Peterson +7 915 1711532


General Physical State
Height (cm) Weight (kg) Shoes Clothes Hair color Eye color


Date applied: 06.06.2021 Signature: [pic]