APPLICATION FORM

DATE: 06.11.2013
Position applied for
Date of availability
Salary expectation
Surname
Name
Date / place of birth
Marital status
Foreign languages

THIRD MATE
25.10.2013
DENISOV
MARCEL
11.03.1979
MARIED
ENGLISH, SPANISH, ITALIAN

PIC

TUR
E

CONTACT INFORMATION
Home address TULCEA, STR. ALUNISULUI, 22

Phone
Mobile
Email

07456 42 4881
marianadenisov33@yahoo.com

PERSONAL DETAILS & UNIFORM INFORMATION

Hair Color
Eye Color
Height (CM)
Weight (Kg)

SATEN
BLUE
170
70

Uniform size
Overall size
Shoes
Nearest airport

HENRY COANDA

NEXT OF KIN DETAILS

Relationship (i.e. Wife, Father etc.)
Name and Surname
NOK Address (if same, write SAME)
NOK Contact Number
Age of Children (if applicable)

WIFE
DENISOV MARIANA
TULCEA, STR. ALUNISULUI, 22

PRE-SEA EDUCATION
Name of school or academy
UNIVERSITY MARITIME OF
CONSTANTA
ACADEMY OF ECONOMIC
STUDIES

Department
FACULTY NAVIGATION AND
SHIPPING

From

To

2008

2012

TOURISME

2002

2006

Date of
issue
04.05.06
26.08.03

Date of
expiry
04.05.16
12.06.14

PERSONAL DOCUMENTS
Name of document
National Passport
National Seamans Book

Number

Place of issue

11610407
12039CT

TULCEA
CONSTANTA

WORK ON SEA CREWING AGENCY Address: 62,Dacia Street, Constanta, Romania Tel: +4 0241 582 475
Mobile: +4 0736 026 709;

+4 0757 620 365 E-mail: office@workonsea.ro website URL: www.workonsea.ro

Name of document
Certificate of Competency
Endorsement
Basic Safety Training
Medical First Aid
Basic Fire Fighting
PSSR
Personal Survival Techniques
Familiarization Safety Training
Transp. and handling of Dang.
Cargoes
Prevention of Pollution MARPOL
Maritime English
Prof. Survival Craft / Rescue Boats
A.R.P.A.
Advanced fire-fighting
Medical Care
Bridge/Engine Team Management
SSO (Ship Security Officer)
GMDSS GOC
Dynamic Positioning Operators
Certificate
Tanker Familiarization
Advanced Oil Tankers Certificate
Advanced Chem. Tk. Certificate
RO-RO Passenger
National Medical Examinations
Vaccination against Yellow Fever
US C1/D Visa

CONSTANTA
CONSTANTA

Date of
issue
04.02.13
04.02.13

Date of
expiry
04.06.16
04.04.16

13110

CONSTANTA

30.05.11

29.05.16

15816
15003
15816
13001

CONSTANTA
CONSTANTA
CONSTANTA
CONSTANTA

03.06.11
24.05.11
03.06.11
19.05.11

02.06.16
23.05.16
02.06.16
18.05.16

12320
8500
24414
177
15482

CONSTANTA
CONSTANTA
CONSTANTA
CONSTANTA
CONSTANTA

12.06.11
07.06.12
05.05.11
02.12.12
08.07.11

11.06.16
07.06.17
04.05.16
02.12.17
07.07.16

274

CONSTANTA
CONSTANTA

01.11.13
12.02.13

01.02.18

2351

CONSTANTA

12.04.13

12.04.18

TULCEA

10.05.13

10.05.23

Number

Place of issue

43271
28273

SEA SERVICE DETAILS

Rank

THIRD
MATE
THIRD
MATE

Company

Name of vessel

Flag

Type

ABEL
MATUTES
ABEL
MATUTES
ABEL
MATUTES

SPAIN

RO RO
PAX
RO RO
PAX
RO RO
PAX
HSC
FERRY
HSC
FERRY
HSC
FERRY

BALEARIA
BALEARIA

AB

BALEARIA

AB

BALEARIA

JAUME I

AB

BALEARIA

JAUME I

AB

BALEARIA

AVE
MARDOS

SPAIN
SPAIN
SPAIN
SPAIN
SPAIN

GRT

Engine / KW

Date From

Date To

29670

2X900

02.05.13

25.09.13

29670

2X900

12.02.13

07.04.13

29670

2X900

15.07.12

15.10.12

3989

4X4230

15.07.11

01.12.11

3989

4X4228

28.12.10

16.04.11

5517

2600

21.05.10

05.11.10

WORK ON SEA CREWING AGENCY Address: 62,Dacia Street, Constanta, Romania Tel: +4 0241 582 475
Mobile: +4 0736 026 709;

+4 0757 620 365 E-mail: office@workonsea.ro website URL: www.workonsea.ro