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EVROMARINE SERVICE Ltd.
93, B.Arnautskaya Str. , 65 007, Odessa, Ukraine, Tel.: [open contact info](look above in the "contact info" section), Fax: [open contact info](look above in the "contact info" section), e-mail: [open contact info](look above in the "contact info" section)
PLEASE! FILL IN BY BLUE COLOUR
1. PERSONAL DISCRIPTION AND INFORMATION

Nationality: Ukrainian
LAST NAME:Gubina
FIRST NAME:Tetyana
FATHER NAME:
APPLICATION DATE:01.03.2016
VESSEL DESTINE FOR
RANK:Stewardess

DO NOT FILL IN

German Language – Communication:Good
Write :Good
Speak :Good
English Language – Communication:Good
Write:Good
Speak:Good
CIVIL STATUS:
Single ; Married ; Divorced ;Married
N. OF KIDS:
Boys - 1
Girls -
BIRTH PLACE:Kyiv reg.

BIRTH DATE:25.01.1964

AGE:52

PHONES:[open contact info](look above in the "contact info" section)

NOMINEE for m.v.:
DO NOT FILL IN
US VISA Yes/No
ISD. EXP.
PERMANENT ADDRESS: -Number – Street - City
20v, Gongadze ave., Kyiv, Ukraine
EDUCATION:
Odessa maritime colledge #26
READY FROM:now

RELIGION:Ortodox

NEXT OF KIN:
Gubin Nickolay
RELATION:
husband
RECOMMENDATION:
NAVAL COLLEGE:

PREFFERED WAGES:
HEIGHT 158
WEIGHT 62
BLOOD GROUP2+
YELLOW FEVER EXP.DATE:22.04.2019

2. LICENCE & CERTIFICATES
Licence
Certificate
Nation.
Number
Issued
D/M/Y
Years
Valid
Licence
Certificate
Nation.
Number
Issued
D/M/Y
Years
Valid
Licence
Certific.
Lec.-Cert.
Nation.
Number
Issued
D/M/Y
Years
Valid
Officer
Ukraine

CDC B-V/b
Ukraine

Endorsement
Ukraine

Sea Passport
Ukraine
ab443911
12.01.2011
12.01.2016

STCW A-VI/1
Ukraine
13741 KS
03.12.2012
31.12.2016
Int. Passport
Ukraine
Ak785990
04.04.2006
04.04.2016

A-VI/2
Ukraine

GMDSS
Ukraine

A-VI/3
Ukraine
0307/2012
10.05.2012
10.05.2017
ROPS
Ukraine

A-VI/4-1
Ukraine

3. PREVIOUS EXPERIENCE
Vessel’s type
Vessel’s name
DWT
Company Name & particulars
Rank
Engine
Type
HP
S/On
date
S/Off
date
Month
S/Off Reason
Cruise liner
DIVINA

MSC
Cabin Stewardess

09.11.2013
12.06.2014
7
Finished Contract
Cruise liner
DIVINA

MSC
Cabin Stewardess

07.12.2012
01.05.2013
5
Finished Contract
Cruise liner
Orient Queen 2

Abou Merhi cruises
Cabin Stewardess

27.08.2012
02.10.2012
1
Finished Contract
Cruise liner
Thomson Destyni

Louise cruises
Cabin Stewardess

10.02.2011
19.11.2011
9
Finished Contract
Cruise liner
Thomson Destyni

Louise cruises
Cabin Stewardess

03.04.2010
15.11.2010
7
Finished Contract
Cruise liner
Thomson Destyni

Louise cruises
Cabin Stewardess

21.05.2009
23.12.2009
7
Finished Contract
Cruise liner
Thomson Destyni

Louise cruises
Cabin Stewardess

18.03.2008
02.10.2008
7
Finished Contract

4. INTERVEWED BY:
NAME & SIGNATURE
DATE:
APPROVED:
REMARKS:
“EVROMARINE SERVICE” / CREW DEP.