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: ETO2167399 Name: Raman Verma
  Address: 274 Bal Nara
Telephone No.: Mobile no: 7018906077
E-mail: ramanverma34@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 ETO2167399 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: ETO2167399
 
Full Name (as per Passport) : Raman Verma
Date of Birth (DD/MM/YY): 14 May 1995 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: N5230272 Date of Expiry: 21 Feb 2026
Place of Issue: SHIMLA Personal Identification Mark: Cut mark near right eye

(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.: 274
Street /Lane: Bal Nara
Village / Post Office / Tehsil: Bal Nara / Galore / Nadaun
City / District: Hamirpur
State: Himachal Pradesh
PIN: 177026
Telephone No. with STD code: 917018906077 Mobile: 7018906077
E-mail: ramanverma34@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2010 Year of Passing: 2012
Board: Himachal Pradesh Board: Himachal Pradesh
English %: 79 English %: 60
Aggregate Percentage: 74 Aggregate Percentage: 65
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 69 69
Chemistry 100 73 73
Mathematics 100 51 51
English 100 60 60
Physics, Chemistry & Mathematics combined Percentage: 64.33
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: MIT Bani
Tel. No.: Tel. No.: 01972215234
Email Id.: Email Id.: info@mithmr.com
Board: University: HPTU 
Year of Joining:
Year of Joining: 2012
Year of Passing: Percentage: Year of Passing: 2016 Percentage: 68
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, Listening music
What are your strengths ? Hard working
What are your weaknesses ? None
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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