Матрос

Описание





APPLICATION FORM

1

Position






Position applied for:
Bosun


Are you willing to accept any other positions?





If YES, which positions would you consider?
Able seaman/Ordinary seaman


Readiness From
25.08.2021









2

Personal details





Name:
(Last Name) Konyashko
(First Names) Denis


Date/place of birth:
05.05.1986 USSR
Nationality:
RUSSIA


Permanent address:
Saint-Petersburg Gatchina 1 Koltsova str.







Post code:
188306
 No.:
+79650614595 WhatsApp


Mailing address:




E-MAIL:
konyashkodenis@mail.ru
 No.:
+79660614595


Height
178
Weight
75
Eye Colour
Brown



Working closes sizes:
Safety shoe, size :
48-50
size :
43









3

Education Background






Name
From Year
To Year
Highest Qualification Attained



School/College
State maritime Academy of
admiral Makarov
2007
2012
Navigator



Marine Education
Navigator






Other Qualifications






4

Identity documents



DOCUMENT
COUNTRY
NUMBER
ISSUED
PLACE
EXPIRY


Passport(tour):
Russia
757313899
24.03.2018
St. Petersburg
24.03.2028


Seaman passport:
Russia
0441834
23.04.2019
St. Petersburg
24.03.2024


Seaman's book:
Russia
0224354
14.05.2014
St. Petersburg
--------------------



Norway
-----------------15.10.2019
15.10.2019
Bergen
---------------------



Marshal Islands
MH 765998
04.06.2021
London
03.06.2026



Panama
P0219197
11.10.2117
Panama
27.09.2022










Do you hold a UK Visa ?

NO






Have you been rejected for any visa applied for?
NO










If YES, please state the country and reasons






5

Family details








NEXT OF KIN Relationship: WIFE


Name:
(Last Name) Konyashko
(First Names) Irina


Address:
Saint Petersburg 3 Burenina str. Room 104




Post code:
185253


Contact telephone numbers:
1st.
+79657771902
2nd.






Names of Children
Sex
Date of Birth


Konyashko Andrey
Men
02.05.2021


Konyashko Diana
Woman
02.05.2021







6

Highest Certificates of Competency held



Class / Grade
Issuing Country
Certificate No.
Date Issued
Place Issued
Valid Until


Able seafarer deck
Russia
1014601000
12.01.2017
Saint Petersburg
--------------------

























6a

Dangerous Cargo Endorsements






Certificate No.
Date Issued
Place Issued
Valid Until























Other






7

Highest Certificates Of Competency issued by other countries (Issued by countries other than in Section 6)





Class
Issuing Country
Certificate No.
Date Issued
Place Issued
Valid Until



























Other





7a

Dangerous Cargo Endorsements (Issued by countries other than in Section 6a)





Country/Type
Certificate No.
Date Issued
Place Issued
Valid Until






























8

Courses attended and certificates obtained



Model
Course
Institution
Place
Date
Cert. No.
Valid Until



BOSIET
REVAL
Tallin
17.04.2019
86895700190419711
18.04.2023



HUET
REVAL
Tallin
17.04.2019
86895700190419711
18.04.2023



CA-EBS
REVAL
Tallin
19.04.2019
86895902190419922
19.04.2023



Basic safety training
Marstar
Saint Petersburg
27.12.2019
620-360/19-06C
27.12.2024



Proficiency in survival craft and rescue boats
Marstar
Sant-Petersburg
14.01.2021
0071795
14.01.2026



Security training for seafarers
With designated security duties
Marstar
Saint-Petersburg
18.05.2021
634-137/21-03C
18.05.2026



Forklift operating and maintenance
Marstar
Saint-Petersburg
22.01.2019
654-021/19-01C
22.01.2024



Security awareness training for
seafarers
Marstar
Saint-Petersburg
11.09.2019
635-284/19-04C
11.09.2024



























































































































































9

Record of previous service


(Please give a full record starting with the last vessel on which you served)
--------------------------------------------------------------------------------

VESSEL
COMPANY[#]
VESSEL TYPE
FLAG
DWT
YEAR BUILT
MAIN ENGINE
B.H.P.
**
RANK
SIGN ON DATE
SIGN OFF
DATE






MAKE
TYPE




DEFIANT
WCC
AHTS
PANAMA
2300
2006



Bosun
24.02.2022
30/09.2022
AGAETE
Red Wise
GC
A&B
3200
1990



AB/Bosun
03.09.2021
22.11.2021
MAINTPORT GEO
Mainport
MPSV
Mar.Isl.
1326
2009



Bosun
19.05.2021
29.06.2021
ORIENT
Red Wise
AHTS
Belize
1260
2015



Bosun
13.02.2021
31.03.2021
VENGERY
Femco
AHTS
Liberia
3736
2010



Bosun
15.06.2020
27.112020
GRIP
Red Wise
RO-RO
Norway
2828
2020



Bosun
06.01.2020
03.03.2020
HILLEFJORD
Red Wise
RO-RO
Norway
2990
2019



Bosun
28.10.2019
16.12.2019
OCEAN SPIRIT
IMG
Drilling
Island
1717
1990



Bosun
08.07.2019
08.082019
OCEAN SPIRIT
IMG
Drilling
Island
1717
1990



Bosun
01.06.2019
01.07.2019
ADELINE
CLDN
RO-RO
Malta
21020
2015



AB
24.01.2019
02.04.2019
KRISTEL
Hansa
GC
Malta
5020
2006



Bosun
04.08.2018
16.11.2018
OCEAN SPIRIT
IMG
Drilling
Island
1717
1990



Bosun
05.04.2018
17.06.2018
ESTESUN
Terramagica
Bulk
Panama
12500
2012



Bosun
09.10.2017
02.03.2018
ILSE
Terramagica
GC
Malta
3500
2001



Bosun
01.02.2017
27.06.2017
ESTESTAR
Terramagica
Bulk
Panama
11000
2010



Bosun
24.03.2016
14.10.2016
SUNNA
NES
GC
Malta
3000
1993



AB
22.09.2015
02.01.2016
ESTESTAR
Terramagica
Bulk
Panama
11000
2010



Bosun
16.02.2015
05.09.2015
































































































# Please ensure that the full name and address of your immediate past employer is entered in section 11 ## ## **Required for engineer applicants o




10

Medical history





Have you ever signed off a ship due to medical reasons?

NO



Have you undergone any operation in the past?

NO



Have you consulted a doctor during the last 12 months for an illness/accident?

NO



Do you have any health or disability problems now?
NO


(If the answer is YES to any of the above, please give full details and attach a separate page if necessary)




11

General





Have you ever been the subject of a court of inquiry or involved in a maritime accident?
NO



Have you ever had a professional license suspended or revoked?
NO


(If YES, please give full details and attach a separate page if necessary)





12

References:





Do you have any objection if we will contact your last employers for reference
reference?
NO







If NO please specify in 12a and 12b:

12a

References (Please give the name and address of your current or immediate past employer)





Name of company
FEMCO MANAGEMENT



Name of person to contact
PAVEL BIKBULATOV



Address
RUSSIA Saint-Petersburg 47 Mahovaya str.








 No.
+78122402938







12b

References (Please list two contactable referees or past employers in addition to Section 11)







Name of company
WORLD INTER



Name of person to contact
ANDREY VLASOV



Address
Saint-Petersburg 3Mezhevoy chanal








 No.
+78125752515







13

Automatic review







If immediate employment is not available do you wish to be considered for future vacancies?
YES



If YES, please give any alternative contact details not shown in Section 2



WhatsApp +79643340160 konyashkodenis@mail.ru



14

Declaration





I hereby declare that the above particulars are true and authorize you to contact the referees listed above.