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


Application Summary
 
Dossier ID: ETO2167329 Name: Rutuja Pravin Patil
  Address: Datta samartha plaza Rajarampuri 10th lane
Telephone No.: Mobile no: 7038779113
E-mail: rutujapatil1998r@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: -
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167329 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________

   
Date ________________ Date ________________
 

 

Please quote your dossier id and full name for any future correspondence
Please check that the following documents are accompanying this application :
  1. Three identical recent passport size photographs (including one attached on the form)
  2. Attested Copies of Class X, XII mark sheet, Age Proof
  3. Attested Copies of Graduation Semester/ Year wise Grade Sheet
  4. Attested Copies of Graduation Certificates
  5. Format of Annex-1 to be printed on college/institute letterhead and submitted along with application form
  6. CGPA / DGPA to percentage conversion letter (if applicable)
  7. Print the application form duly filled
  8. Send the hard copy of application form along with necessary documents to TMI, Induri
  9. Send filled application forms to Admissions Cell (ETO), Tolani Maritime Institute, Induri Village, Talegaon Chakan Road, Talegaon Dabhade, Pune, PIN- 410507

     
     

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: ETO2167329
 
Full Name (as per Passport) : Rutuja Pravin Patil
Date of Birth (DD/MM/YY): 05 Mar 1998 Nationality: Indian
Gender (M/F): Female Marital Status (Single/Married): Single
Passport No.: T3325515 Date of Expiry: 09 Apr 2029
Place of Issue: Pune Personal Identification Mark: Mole on right shoulder

(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.: Datta samartha plaza
Street /Lane: Rajarampuri 10th lane
Village / Post Office / Tehsil: Rajarampuri post office
City / District: Kolhapur
State: Maharashtra
PIN: 416008
Telephone No. with STD code: Mobile: 7038779113
E-mail: rutujapatil1998r@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2013 Year of Passing:
Board: Maharashtra Board:
English %: 73 English %:
Aggregate Percentage: 76 Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
English
Physics, Chemistry & Mathematics combined Percentage:
   
   

Diploma:

Graduation:
Diploma Specialization: Electronics and Telecommunication Engineering Degree Specialization: Electronics and Telecommunication Engineering
Name of Polytechnic: Bapuji Salunke institute of technology Name of College: Sanjay Ghodawat institute of engineering and technology
Tel. No.: 0738657473 Tel. No.: 02302463700
Email Id.: bsieat@gmail.com Email Id.: director@sginstitute.in
Board: Maharashtra State board of technical education University: Shivaji University 
Year of Joining: 2013
Year of Joining: 2016
Year of Passing: 2016 Percentage: 78 Year of Passing: 2019 Percentage: 66
Medium of Instruction: English 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 ? Drawing, listening music
What are your strengths ? Multitasking, gets adjusted in new environment and people
What are your weaknesses ? Shopping
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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