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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
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Dossier ID: ETO2167356 |
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Full Name (as per Passport) : Zargham Haider |
Date of Birth (DD/MM/YY): 21 Sep 1999 |
Nationality: India |
Gender (M/F): Male |
Marital Status (Single/Married): Single |
Passport No.: |
Date of Expiry: |
Place of Issue: |
Personal Identification Mark: I have many sesame on my body |
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(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 -
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House / Building No.: Ismat colony, Yadav bazaar, near haji colony , |
Street /Lane: Yadav bazaar, dubbaga |
Village / Post Office / Tehsil: Sikrauri, kakori |
City / District: Lucknow |
State: Uttar Pradesh |
PIN: 226027 |
Telephone No. with STD code: |
Mobile: 9369686563 |
E-mail: zarghamh10@gmail.com |
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Academic Record - |
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Class X: - |
Class XII: - |
Year of Passing: 2015 |
Year of Passing: 2017 |
Board: Uttar Pradesh |
Board: Uttar Pradesh |
English %: 88 |
English %: 63 |
Aggregate Percentage: 76 |
Aggregate Percentage: 64 |
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Details of Marks Secured in (10+2) Examination - |
SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
Physics |
100 |
81 |
81 |
Chemistry |
100 |
61 |
61 |
Mathematics |
100 |
56 |
56 |
English |
100 |
63 |
63 |
Physics, Chemistry & Mathematics combined Percentage: |
66 |
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Diploma: |
Graduation: |
Diploma Specialization: |
Degree Specialization: Electrical Engineering |
Name of Polytechnic: |
Name of College: Bansal Institute of engineering and technology |
Tel. No.: |
Tel. No.: 8924090526 |
Email Id.: |
Email Id.: zarghamh10@gmail.com |
Board: |
University: Abdul kalam Technical University |
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Year of Passing: |
Percentage: |
Year of Passing: 2021 |
Percentage: 64 |
Medium of Instruction: |
Medium of Instruction: English medium |
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Note: Diploma/Degree courses must be recognised by any State or Central Government or the AICTE. |
Other Qualification, if any -
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Work Experience, if any - |
Name of the Firm |
Designation |
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What are your hobbies ? Playing cricket, football, and listening music or motivational speech |
What are your strengths ? Working with team or enjoying a work in good atmosphere |
What are your weaknesses ? Frank and early trusted person |
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Declaration
I hereby declare that all the statements made above are true and correct. |
Signature of Candidate |
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___________________ |
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Date ________________ |
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