APPLICATION FORM

PHOTO

JOINING RANK: 2ND OFFICER

SEAFARER’S PERSONAL DETAILS

SURNAME: DUDINOV DATE OF BIRTH: 22.12.1985 MARITAL STATUS: MARRIED

NAME: YURY PLACE OF BIRTH: russia NO OF CHILDREN: 1

FATHER’S NAME: ALEKSEY NATIONALITY/ RELIGION: NEXT OF KIN (NAME/SURNAME):

ORTHODOX DIANA LAZIAN

MOTHER’S NAME: GALINA TEL.NO: +995422278003 NEXT OF KIN (RELATION):WIFE

ADDRESS: MOBILE: +995558594838 NEXT OF KIN (CONTACT No):

Georgia,Batumi,Chavchavadze str113 +995555253491
app24

SKYPE:dudinov85 EMAIL: yuradudinov@mail.ru NEAREST AIRPORT: BATUMI

BIOMETRIC DATA:
HEIGHT WEIGHT OVERALL SIZE SHOES SIZE
(IN CM) (IN KGRS) (EU)
185 83 XL 45

EDUCATION:
NAME OF INSTITUTE FROM TO QUALIFICATION
Batumi Navigation Institute 2003 2006 Navigator

PRACTICAL EXPERIENCE:
INSPECTIONS PORT COMPANY

VETTING KASHIMA BP
CLASS
TRADING AREA OF LAST 3 USA,VENEZUELA,CHINA,JAPAN,CURACAO,SINT
CONTRACTS EUSTATIUS,BONEIRO,SOUTH KOREA,SINGAPORE
 PUMPS EXPERIENCE CENTRIFUGAL ,FRAMO

NATIONAL DOCUMENTS
DOCUMENT NUMBER ISSUE DATE EXPIRY DATE PLACE ISSUED
PASSPORT 759486660 24.10.2018 24.10.2028 RUSSIA
NATIONAL SEAMAN’S GE007640 21.07.2015 21.07.2020 GEORGIA
BOOK

RANK OF NATIONAL CHIEF OFFICER

LICENSE:
NATIONAL LICENSES AND TRAINING CERTIFICATES
COURSE CERTIFICATE NUMBER ISSUE DATE EXPIRY DATE
COC (Certificate of Competency) 16F02-04-003230-01 14.07.2016 14.07.2021

GMDSS 15F09-23-001413-01 11.08.2015 17.07.2020

BASIC TRAINING FOR OIL
AND CHEMICAL TANKER

ADVANCE OIL TANKER OCG02-050528 21.09.2015 13.08.2020

TRAINING
ADVANCE CHEMICAL OCG02-050782 22.09.2015 24.08.2020
TANKER TRAINING
BASIC SAFETY TRAINING 12.08.2015 27.06.2020
(Personal Survival Techniques- BST02-049313
Firefighting- First aid - Personal
Safety & Social Responsibilities)
PROFICIENCY IN SURVIVAL FRB02-049315 12.08.2015 30.07.2020
CRAFT & RESCUE BOATS
ADVANCED FIRE-FIGHTING AFT02-049318 12.08.2015 03.07.2020

MEDICAL FIRST AID

MEDICAL CARE MFC02-050330 10.09.2015 02.09.2020
SHIP SECURITY OFFICER SSO02-049314 12.08.2015 26.07.2020
SHIP SECURITY AWARENESS SEC02-050578 16.09.2015 09.09.2020
DESIGNATED SECURITY SEC02-050578 16.09.2015 09.09.2020
DUTIES
ARPA RNA02-049317 12.08.2015 23.07.2020
(Automatic Radar Plotting Aids)

ECDIS (Electronic Chart Display and ECS02-049316 12.08.2015 13.07.2020

Information Systems)
ECDIS Type Specific Training 35828/111192 (JRC) 11.11.2015 N.A
(JRC for Lotus vessels)
BTM / BRM (Bridge Team BTM02-069353 24.02.2017 17.02.2022
Management/Bridge Resource
Management)
ERM (Engine Room Resource
Management)
RISK ASSESSMENT
INCIDENTINVESTIGATION
SHIP HANDLING AND
MANOEUVRING
SHIP SAFETY OFFICER
COW/IGS IGC02-050527 15.09.2015 06.09.2020
Leadership & Teamwork LDT02-060692 24.06.2016 17.06.2021
ADDITIONAL
MEDICAL OBSERVATION: ISSUE DATE EXPIRY DATE
NATIONAL MEDICAL 16.03.2018 16.03.2020
FLAG MEDICAL 16.03.2018 (Marshall Islands) 16.03.2020
OTHER MED. DOCS 08.01.2019 (Drug & Alcohol)
YELLOW FEVER VACCINATION 04.11.2015 04.11.2025
LANGUAGE KNOWLEDGE
ENGLISH FAIR: GOOD: VERY GOOD:V
RUSSIAN FAIR: GOOD: VERY GOOD:V
OTHER (Georgian) FAIR: GOOD: VERY GOOD:V

SEA SERVICE RECORD

VESSEL’S FLAG TYPE DWT YEAR M/E TYPE RANK OPERATOR SIGN SIGN
NAME OF ON OFF
BUILT DATE DATE
RIO CARONI M.I. OIL TNK 158777 2003 B&W/6S70MC- 2ND OFF Bernhard Schulte 18.03.2018 14.08.2018
C/25023 Shipmanagement
RIO CARONI M.I. OIL TNK 158777 2003 B&W/6S70MC- 2ND OFF Bernhard Schulte 13.06.2017 13.11.2017
C/25023 Shipmanagement
RIO CARONI M.I. OIL TNK 158777 2003 B&W/6S70MC- 2ND OFF Bernhard Schulte 03.10.2016 31.01.2017
C/25023 Shipmanagement
RIO CARONI M.I. OIL TNK 158777 2003 B&W/6S70MC- 3RD OFF Bernhard Schulte 27.08.2016 02.10.2016
C/25023 Shipmanagement
RIO ORINOCO M.I. OIL TNK 158589 2003 B/W/22790 3RD OFF Bernhard Schulte 20.12.2015 08.06.2016
Shipmanagement
CHEM ALYA M.I. OIL CH 17055 2007 MAN/6600 3RD OFF Bernhard Schulte 27.10.2014 24.04.2015
TNK Shipmanagement
TAI HU SIN CR OIL 73980 2001 B/W/15153 3RD OFF Ocean Tankers 06.05.2013 12.11.2013
TNK
OCEAN LEADER SIN CH /OIL PR 16626 2008 B/W/8448 3RD OFF Ocean Tankers 05.07.2012 23.02.2013
TNK

REFERENCES
COMPANY
COMMENTS