1. APPLICATION FOR EMPLOYMENT
SURNAME Kotlyk POSITION APPLIED FOR: Crane Operator
Photo
GIVEN NAME: Yevhen MARITAL STATUS: Married
FATHER’S NAME: Ivanovich NUMBER OF CHILDREN: two
DATE/PLACE OF BIRTH: 21.01.1987 NEXT KIN: Kotlyk Viktorya
CITIZENSHIP: Ukraine RELATION: Wife
ADDRESS: Odessa region, p.g.t Velikodolinskoe,
ul.Entuziastov, d-8 kv-509
NEXT KIN ADDRESS: Odessa region, p.g.t Velikodolinskoe,
ul.Entuziastov, d-8 kv-509
PHONE: +(38)-099-250-57-47
e-mail: kotlik.jen@yandex.ru
PHONE: +(38)-066-197-83-78; +(38)-096-767-91-36;
NAME OF SCHOOL: CITY GRADUATED TYPE OF DEGREE RECEIVED:
PASSPORTS: Number/ Place of Issue ISSUED VALID
SEAMAN’S PASSPORT: AB467828 28.03.2011 28.03.2016
TRAVELLING PASSPORT: ET581115 29.12.2011 29.12.2021
OTHER:
LICENCES GRADE NO. ISSUED VALID
CERTIFICATE OF COMPETENCY: Second class seaman 10699 18.07.2014 without
limitation
ENDORSEMENT:
GMDSS:
ENDORSEMENT:
OTHER:
US Visa Type / Expire date
STCW CERTIFICATES № VALID STCW CERTIFICATES № VALID
Basic Safety Training and Instruction 111237 28.05.19
Security Training For Seafarers 09076 04.12.18
Proficiency in Survival Craft 04581 04.12.18
Ships Crane Driving 41288 Infinite
Ships Crane Operator 0112 Infinite
I have experience:
LIEBHERR Electro-hydraulic FCC-
CBG; CBW
Floating crane
All types of ship cranes
HEALTH CERTIFICATE DATE: Valid -05.01.2016 YELLOW FEVER: Valid -14.10.2022
WEIGHT:85 CLOTHES:52 SHOES:43 HEIGHT: 182 ENGLISH LEVEL SatisfactorySatisfactory
VESSEL’S NAME COMPANY FLAG Type DWT ENGINE BHP RANK Date on-Date Off
Samba Marlow Navigation Antigua&
Barbuda
Container 8199,6
682 TEU
MAK 7200 A/B Crane
Operator
07.05.2015-
10.09.2015
Tango ex Sina Marlow Navigation Antigua&
Barbuda
Container 5312.1
505 TEU
MAK 4320 A/B Crane
Operator
28.09.2014-
17.03.2015
Tango Marlow Navigation Antigua&
Barbuda
Container 5312.1
505 TEU
MAK 4320 O/S Crane
Operator
09.12.2013-
17.05.2014
Hamburg Tech Project Dominica Bulker 41000 MAK 11000 Crane
Operator
05.01.2013-
05.07.2013
Don Bass Tech Project St. Kitts&
Nevis
General Cargo 9514 Wartsila 6300 Crane
Operator
12.05.2012-
10.10.2012
Don Star Tech Project St. Kitts&
Nevis
General Cargo 9470 Wartsila 6300 Crane
Operator
30.10.2011-
15.04.2012
Don Star Tech Project St. Kitts&
Nevis
General Cargo 9470 Wartsila 6300 Crane
Operator
18.04.2011-
18.10.2011
