APPLICATION FOR EMPLOYMENT Form #:

Maritime Union Application Date:2023-07-24

Personal Data

Application ID:353623

Department: Engine Nationality: Ukraine

Rank: Reefer Sea service (years): 1-3

Engineer
Surname: Nimchuk Nearest airport: All Airports

First name: Andrii Place of birth: Ukraine Nova Ushytsya

Date of birth: 18.09.1992 Marital status: Not married

Country of residence: Spain Tel. No.: -

City: alicante Mobile: -

Address: - Skype: -

Post code: 03181 FaceBook ID: -

Ready for positions

Position Vessel Type Salary per month Duration of contract(Months)

Engine / Reefer Engineer Dry cargo Fleet / Reefer 5000USD N/A
Documents

Document Number Valid until Issued By Issued at Note

Work Diploma 05008/2022/08 05.08.2027 05.08.2022 Ukraine N/A
Seaman's book AB604791 12.10.2025 28.03.2017 Ukraine N/A
National passport FJ917204 09.11.2027 09.11.2017 Ukraine N/A
Marine training courses / Certificates

Name Number Valid until Issued by Issue at

BASIC FIRE FIGHTING 1476549 27.07.2027 27.07.2022 Ukraine
PROFICIENCY IN SURVIVAL CRAFT AND RESCUE BOATS 1474585 27.07.2027 27.07.2022 Ukraine
BASIC SAFETY TRAINING 1474489 27.07.2027 27.07.2022 Ukraine
MEDICAL FIRST AID 1474558 27.07.2027 27.07.2022 Ukraine
SECURITY AWARENESS TRAINING 1474047 27.07.2027 27.07.2022 Ukraine
Endorsement

Name Number Valid until Issued by Issue at Note

Refrigerator engineer officer 05008/2022/08 05.08.2027 05.08.2022 Ukraine N/A
Education

Education type Name Qualification Graduated (Completed) Country

Odesa maritime college of fishing industry
College Refrigeration plants engineer 2019 Ukraine
named Oleksii Solyanyk
Languages

Print Date:2023-07-24
Page 1
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 APPLICATION FOR EMPLOYMENT Form #:
Maritime Union Application Date:2023-07-24

Language Level
English Intermediate
Ukrainian Native
Russian Native

Test levels Score

Test name Date Score Company Country Note

CES TEST 11.05.2022 80 Laskaridis Shipping Company Greece N/A
Vaccinations

Name Issued date Issued by Issue at

Yellow Fever 28.05.2021 28.05.2021 Ukraine
Sea Service records

Vessel Type of
#: From - Till: Flag: DWT: Enginie: BHP: KW: GRT: Position: Company Name:
Name: vsl:
28.05.2021 - Trainee Rosse
1 Frio Aegean Panama 6973 Akasaka N/A 7060 N/A Reefer
14.01.2022 Engineer Oceanway S.A.
12.09.2022 - Reefer Rosse
2 Frio Aegean N/A 6973 Akasaka N/A 7060 N/A Reefer
03.05.2023 Engineer Oceanway S.A.
Next of kin

Full name Relationship Country City Address Tel. No. Mobile Skype Email
Dviborodchyna Vitalina Other Spain Torrevieja - - - - -
Uniform
Weight Height Colour of eyes Colour of hair Boots size Boilersuit size
89 190 Green Brown 44 XL

Print Date:2023-07-24
Page 2
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