Akvašips SIA (Aquaship Form No: 05-19/01

Ltd) APPLICATION FORM Page: 1/2

Surname, name (Sbook): Murenkov Oleg

Ф.И.О. (Russian):
Date of birth / Place of birth: 1982 05 26
Photo
Citizenship / Personal code (if any): Lithuanian 38205260702(LT)
Address: P.KOMUNOS.10-5 KLAIOPEDA LT
Phones: 37061475118
Marital Status: NOT MARRIED IN RELATIONSHIP
Next of kin / relationship: M NIKOLAJ /FREND

POSITION APPLIED FOR: AB'S

Marine Education History

Name of School Dates Attended
Grade (Capacity)
College/Institue/Academy/Courses From To
College/Institue/Academy/Courses 2003 2009 Graduated
College/Institue/Academy/Courses 2003 2009 Seaman cook

Details of Licenses/Certificate of Competence

Certificate Grade/Capacity Number Date of issue Date of expire Place of issue
Certificate
ABBLE SEAMAN 03579/02 06 19 06 2011 06 22 LT
of competence
+Endorsement
(for officers only)

Documents and Certificates Number Date of issue Date of expire Place of issue
Seaman`s book (Seaman`s passport) JK032201 270707 270712 LT
Passport 21129922 16 07 2007 16 07 2017 LT
SOLAS 1164/2006 JUNE1206 JUNE 08 11 LT
Proficiency in survival craft 3030/2008 10 22 2008 09 26 2013 LT
Advanced Training in fire fighting
Medical Care
Medical First Aid
ARPA / RLT
GMDSS General Operator
AIS (Automatic Identification System)
Ship Security Officer
Oil tanker Advanced (Special) course
Oil tanker Familiarization course
Medical Examination Certificate 2009 2010
Yellow Fever
US visa
Orther
Seafarer's Book

Aquaship Crewing Department:+371 7804900,7804902,7804903,7804904; fax:+371 7804901; E-mail: crewing@ship.lv; www.ship.lv

PREVIOUS EXPERIENCE (FOR LAST 10 YEARS)

Type of Type of Employment

Rank Vessel's name Flag DWT GRT BHP Crewing Company / Country
vessel engine From To
Julietta A&B GOD Germany 7406 4320 ASKOLDAS /LT 2002 2003

SPECIAL NOTES
PERSONAL DATA
Colour
Colour Boiler Safety

(For Company's use)

Weight Height
of of hair suit shoes
eyes
DARK 110 185 46-48 8

Hereby I affirm that all information provided by me in this form is true and correct
to the best of my knowledge.
Have no objection all my personal data(s) be passed for proper handing,
filing/database and placing of contract

Applicant's signature ____________________Date ______________