Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Electro-Technical Officers Course
(Pre-sea Training & Certification for Merchant Ships)

APPLICATION FOR ADMISSION - March 2021
Dossier ID: ETO2167297
 
Full Name (as per Passport) : Sumit Bujharat Singh
Date of Birth (DD/MM/YY): 29 Jun 1999 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: No

(Note: If you do not have passport, you may apply for it as early as possible as passport is required for obtaining Seaman’s Discharge Certificate, mandatory for boarding a ship.)
Addresses & Contact Details -
House / Building No.: House no 582
Street /Lane: Near Darbai talav, Subhashnagar
Village / Post Office / Tehsil: Ambepur / Poynad
City / District: Alibag
State: Maharashtra
PIN: 402108
Telephone No. with STD code: Mobile: 8983746335
E-mail: sumitbsingh2@gmail.com  
 

Academic Record -

  
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: Maharashtra Board: Maharashtra
English %: 69 English %: 60
Aggregate Percentage: 81 Aggregate Percentage: 64
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 64 64
Chemistry 100 48 48
Mathematics 100 55 55
English 100 60 60
Physics, Chemistry & Mathematics combined Percentage: 55.67
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical Engineering
Name of Polytechnic: Name of College: FCRIT vashi
Tel. No.: Tel. No.: 02227660619
Email Id.: Email Id.: abhishek.shiwalkar@fcrit.ac.in
Board: University: Mumbai University 
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2020 Percentage: 59
Medium of Instruction: Medium of Instruction: English

Note: Diploma/Degree courses must be recognised by any State or Central Government or the AICTE.
Other Qualification, if any -

Work Experience, if any -
Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Playing Outdoor Games , All type of sports
What are your strengths ? I finished the work in given time
What are your weaknesses ? Stage fear
 
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate
 

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Date ________________