Судовой механик на плавкран

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Application Form


Position applied for:
Date available:
SURNAME
GROM
NAME
DMYTRO
FATHER'S NAME
STEPANOVICH
Date and place of birth
01.09.1957 Melitopol
Address,
City Sevastopol
Ave. Ostryakova str.
Personal civil code:
House 193 Apt. 23
Mob +79787721298
Height 168
Weight 76
Overall -50-52
Shoes 40
Eyes blue
Hair brown
E-Mail : dimagrom57@mail.ru
ICQ :
SKYPE :
Yellow Fever valid

Title of the document
№
Date
place of issue
Valid up
Seaman's book
RUS0599837
08.11.2022
Novorossiysk
07.112027
National passport
75 2437307
19.10.2015
Krasnodar 19.10.2025
Foreign passport




Cyprus passport




Panama passport




Other passport




Certificate of competency
NVS205396187
16.02.2022
Novorossiysk 11.01.2027
Rank
Chief Engineer
Endorsement
NVS205396187
16.02.2022
Novorossiysk
11.01.2027
Others Professional license



Rank

Endorsement




GMDSS operator




Endorsement




Basic Safety Training STCW-95
3622001111/912
11.012022
Sevastopol
11.0120.27
Advanced Training in Fire Fighting
42220120/9128
20.0120.22
Sevastopol
20.01.2027
Medical Emergency - First aid
1220114/9128
14.01.2022
Sevastopol
14.01.2027
Proficiency in Survival craft
532200119/9128
19.01.2022
Sevastopol
19.01.2027
Medical Care on Board Ship




Radar Navigation-Managemen Level




Ship Handling Arrangements




Security - related traning for all seafarers
16220117/9128
17.01.2022
Sevastopol
17.01.2027
Ships Security Officer A, B




Advanced training for oil tanker cargo operations




Oil Tanker Familiarition




Dangerous and Hazardous Substan.




Crude Oil Washing of Oil Tankers




Cmk tank familiar/special/adv training




LGtank familiar/special/adv training




Other foreign languages
Second (relative) specialty
Lathe machine skills
Welding skills
PC knowledge Certificate
Valid USA visa
Minimum acceptable salary _$



PREVIOUS SEA EXPERIENCE (FOR LAST 10 YEARS):
RANK
NAME OF THE VESSEL
TYPE VESSEL
YEAR OF BUILD
DWT
TYPE OF THE MAIN ENGINE
FROM
TILL
COMPANY


FLAG

HP




Ch/eng
ALLA
Yacht

285
DETROIT
18.05.12
03.10.12
Kaalbye yacyt llc


Sant Vinsent

2800




Ch/eng
AZOV
REEF

2850
SKL
05.02.13
30.06.13
Linart Ltd


UKR

2372




Ch/eng
TFM-1
Ro-Ro

5775
Volvo Penta
23.08.14
31.12.14
Black Sea Ferry and Investment LLC


Russia

3000




Ch/eng
Conro Trader
Ro-Ro

3998
MAK
30.05.15
29.12.15
Techno Team Marine


Russia

2600




Ch/eng
MELA
Tanker

1896
8NVD48A-2U
27.08.16
27.11.16
Aliotra Group INC


Moldova

1186




Ch/eng
LEON
Tug

80
Caterpillar
11.12.16
13.07.17
Cranchip


Rus

1476




Ch/eng
VELA
Yacht

285
MAN
02.09.17
20.01.18
Kaalbye yacht llc


Sant Vinsent

3200




Сh/eng
LEON
Tug

80
Caterpillar
03.04.18
11.04.19
Cranchip


Rus

1476




2-eng
STVOR
Research

2490
CEGELSKI
SULZER
15.01.20
24.10.22
HYDROGRAPHY


RUS

4200




2-eng
YURIY BELOV
Recearch

150
DEUTZ
09.01.23
27.06.23
HYDROGRAPHY


RUS

1500




MARINE EDUCATION RECEIVED
NAME OF SCHOOL
FROM
TILL
TYPE OF DEGREE RECEIVED
Kherson secondary marine school

1983
1986
Engineer-mechanic
ADDITIONAL INFORMATION
Marital status:
Religion:
Wife
(Name, First name, Date and place of birth)
Elena --wife

Grom/Filimonova/ 02.01.1960
Children under the age of 18 (names, date of birth )



Children under the age of 18 (names, date of birth )



Next of kin (Name, date of birth, address, phone #)
Elena Grom /02.01.1960


LEVEL ENGLISH TEST
English language knowledge
Excellent

Good

Satisfactory

Poor
>
Computer proficiency
Excellent

Good

Satisfactory
>
Poor


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I, undersigned, confirm all above information to be true and correct to my best knowledge:

2024 Signature of the Applicant _Hrom Dmytro_______________