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: ETO2167457
 
Full Name (as per Passport) : DEEPAK PATHAK
Date of Birth (DD/MM/YY): 20 Sep 1993 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Z4049339 Date of Expiry: 24 Oct 2026
Place of Issue: LUCKNOW Personal Identification Mark: TILL ON RIGHT SIDE OF CHEEK

(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.: 1560
Street /Lane: 1
Village / Post Office / Tehsil: BHASOT,PANWARA,MACHHALISAHAR
City / District: JAUNPUR
State: Uttar Pradesh
PIN: 222202
Telephone No. with STD code: Mobile: 8860045295
E-mail: deepakpathak20091993@gmail.com  
 

Academic Record -

  
Class X: - Class XII: -
Year of Passing: 2008 Year of Passing: 2010
Board: Uttar Pradesh Board: Uttar Pradesh
English %: 70 English %: 62
Aggregate Percentage: 64 Aggregate Percentage: 76
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 83 83
Chemistry 100 72 72
Mathematics 100 88 88
English 100 62 62
Physics, Chemistry & Mathematics combined Percentage: 81
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: dr k n modi university newai rajasthan
Tel. No.: Tel. No.: 8875010001
Email Id.: Email Id.: info@dknmu.org
Board: University: rajasthan 
Year of Joining:
Year of Joining: 2011
Year of Passing: Percentage: Year of Passing: 2015 Percentage: 73
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
pulse magnetic and power electronics pvt ltd production engineer 02 Jan 2016 07 Jan 2021
       
       
 
What are your hobbies ? think and apply new creation
What are your strengths ? quick learner,easily adopt changes
What are your weaknesses ? no major weakness
 
 
Declaration

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

Signature of Candidate
 

___________________
 

Date ________________