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: ETO2167374 Name: Palani Selvaraj
  Address: No 47, Sobha Turquoise Harishree Garden
Telephone No.: Mobile no: 7907255477
E-mail: plnslvrj@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 390516787
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167374 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: ETO2167374
 
Full Name (as per Passport) : Palani Selvaraj
Date of Birth (DD/MM/YY): 17 Mar 1995 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: K0044463 Date of Expiry: 21 Dec 2021
Place of Issue: Chennai Personal Identification Mark: Scar on the left eyebrow

(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.: No 47, Sobha Turquoise
Street /Lane: Harishree Garden
Village / Post Office / Tehsil: Sundapalayam
City / District: Coimbatore
State: Tamil Nadu
PIN: 641007
Telephone No. with STD code: Mobile: 7907255477
E-mail: plnslvrj@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2010 Year of Passing: 2012
Board: Tamil Nadu Board: Tamil Nadu
English %: 65 English %: 86
Aggregate Percentage: 74 Aggregate Percentage: 75
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 78 78
Chemistry 100 62 62
Mathematics 100 58 58
English 100 86 86
Physics, Chemistry & Mathematics combined Percentage: 66
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electronics and Instrumentation
Name of Polytechnic: Name of College: Karunya University
Tel. No.: Tel. No.: 04222614300
Email Id.: Email Id.: info@karunya.edu
Board: University: Karunya University  
Year of Joining:
Year of Joining: 2012
Year of Passing: Percentage: Year of Passing: 2016 Percentage: 89
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
Tata Elxsi Embedded Developer 01 Jul 2016 31 Mar 2017
       
       
 
What are your hobbies ? DIY projects, Cycling
What are your strengths ? Communication, Resilience
What are your weaknesses ? Too Honest, Sometimes Sensitive
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
Print Summary and Application Form