Contact information

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Additional information

Application Form

Name:Andriy
Surname: Kyryliv
Date of birth:07.12.1971
Place of birth: Drogobich
Permanent address: Ukraine, Drogobich, Samborskaya 64/3.kv.14
Phone: [open contact info](look above in the "contact info" section) ,
Passport (OVIR) №: EH765691
Place of issue: Drogobich
Date of issue: 18.03.11
Valid until:18.03.21
Seaman’s book №: AB 464451
Place of issue: Izmail
Date of issue: 10.03.11
Valid until: 10.03.16
Citizenship: Ukraine
Expiry date of U.S. visa:
Marital Status:
Married Single Divorced Widower
Next of kin: (name, pas. No)

Supported children under age of 18
1.
(name, surname, date of birth)
2.
Knowledge of English language:
Very good Good Satisfactory Fair Poor
Other language knowledge:

Education:
Qualification
No Diploma
Date of Issue
Drogobich College
Specialist
PT-03619
1988-1992

OSMA
Specialist
Лг 006476
1992-1998

Certificates of STCW 78/95
No.
Place
Date of issue
Expiry date
Basic Safety Training
27245KS
Kyiv, Ukraine
16/12/2015
16/12/2020
Proficiency in Survival Craft
22229KS
Kyiv, Ukraine
18/12/2015
18/12/2020
Proficiency in Fast Rescue Boats

Advanced Fire Fighting
22305KS
Kyiv, Ukraine
12/12/2015
12/12/2020
Medical First Aid
6379KS
Kyiv, Ukraine
09/12/2015
09/12/2020
Medical Care

GMDSS Certificate

GMDSS Endorsement

Radar Observation & Plotting

Engine-room resourcemanagement
4201KS
Kyiv, Ukraine
15/12/2015
15/12/2020
Dangerous & Hazardous Cargoes
12714KS
Kyiv, Ukraine
13/12/2015
13/12/2020
Hazardous materials

Ships Safety Officer

Ships Security Officer
Isolating Breathing Apparatus

RO-RO Passenger Ship

RO-RO Ship

Oil Tanker Familiarization

Oil Tanker Specialized Training

Gas Tanker Familiarization

Gas Tanker Specialized Training

Chem. Tanker Familiarization

Chem. Tanker Specialized Training

Crude Oil Washing

Inert Gas Systems

Bridge Resource Management

Vapor Recovery Systems

Refresher & Updating

Maintenance of Electrical
and Electronic Engineering
31/2003
Izmail, Ukraine
22.02.03

Sea service (during five last years):
Name of vessel
COMPANY
DWT
Flag
Type
Position
Period of service

From
To
1
Lime
Tedial Shipping ltd
2457
UA
Dry Cargo
Second engineer
18.04.11
22.08.11
2
Lime
M&P Lime shipping company
2457
Moldova
Dry Cargo
Second engineer
08.12.11
14.05.12
3
Selim-1
Impuls ltd.
2592
UA
Dry Cargo
Second engineer
01.10.13
31.01.13
4
Selim-1
Impuls ltd.
2592
UA
Dry Cargo
Second engineer
24.07.13
21.11.13
5
Amur-2507
Ariadna shipping ltd.
3086
Cambodia
Dry Cargo
Second engineer
05.05.14
31.10.14
6
Amur-2507
Ariadna shipping ltd.
3086
Cambodia
Dry Cargo
Second engineer
22.05.15
27.10.15
7

Main Engine Maker
Main Engine
Total H.P.
Aux.Engine
Maker/
Number’s
Aux.Engine
H.P./kW
Voltage
(220/380/
440)
Automation
class
(A1/A2)
Automation
Systems
Maker
Crane/Maker/
Type/SWL
Derrick/Maker
Type/SWL
1
Disel Shkoda 6-27,5-A2L
1030
Disel Shkoda
80+80
220
A3

2
Disel Shkoda 6-27,5-A2L
1030
Disel Shkoda
80+80
220
A3

3
Disel Shkoda 6-27,5-A2L
1030
Disel Shkoda
80+80
220
A3

4
Disel Shkoda 6-27,5-A2L
1030
Disel Shkoda
80+80
220
A3

5
Disel Shkoda 6-27,5-A2L
1030
Disel Shkoda
80+80
220
A3

6

7

National licenses ,Flag state passports, licenses, visas and other documents
Document
Number
Issued
Valid
Issued Place
CERTIFICATE OFCOMPETENCY
15509/2015/07
24.12.2015

Nikolaev, Ukraine
ENDORSEMENT

15509/2015/07

24.12.2015
22.12.2020
Nikolaev, Ukraine

CERTIFICATE OFCOMPETENCY

15510/2015/07
24.12.2015

Nikolaev, Ukraine
ENDORSEMENT
Second class - engineer
Chief engineer (750-3000)
15510/2015/07
24.12.2015
22.12.2020
Nikolaev, Ukraine

Experience at sea: 65 month
Knowledge Personal Computer (Yes / No): Yes

Medical Certificate №
Issued:
Place:
Exp.date:
Vaccination for cholera valid until:
Vaccination for yellow fever valid until:

Ready to work from:_________ __________
Your last salary –
Expected salary -

Date: __________ Signature __________