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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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| Application Summary |
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| Dossier ID: ETO2167465 |
Name: SHIRODKAR JAY RAJENDRA |
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Address: 5,KRISHNA NIWAS N.M.JOSHI MARG |
| Telephone No.: |
Mobile no: 8097903558 |
| E-mail: jshirodkar36@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 1200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 396135245 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167465 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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___________________ |
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| Date ________________ |
Date ________________ |
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| Please quote your dossier id and full name for any future correspondence |
| Please check that the following documents are accompanying this application : |
- Three identical recent passport size photographs (including one attached on the form)
- Attested Copies of Class X, XII mark sheet, Age Proof
- Attested Copies of Graduation Semester/ Year wise Grade Sheet
- Attested Copies of Graduation Certificates
- Format of Annex-1 to be printed on college/institute letterhead and submitted along with application form
- CGPA / DGPA to percentage conversion letter (if applicable)
- Print the application form duly filled
- Send the hard copy of application form along with necessary documents to TMI, Induri
- Send filled application forms to Admissions Cell (ETO), Tolani Maritime Institute, Induri Village, Talegaon Chakan Road, Talegaon Dabhade, Pune, PIN- 410507
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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: ETO2167465 |
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| Full Name (as per Passport) : SHIRODKAR JAY RAJENDRA |
| Date of Birth (DD/MM/YY): 17 Dec 1993 |
Nationality: INDIAN |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Passport No.: S8278841 |
Date of Expiry: 18 Sep 2028 |
| Place of Issue: Mumbai |
Personal Identification Mark: MOLE ON THE NECK |
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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.: 5,KRISHNA NIWAS |
| Street /Lane: N.M.JOSHI MARG |
| Village / Post Office / Tehsil: CHINCHPOKLI |
| City / District: MUMBAI |
| State: Maharashtra |
| PIN: 400011 |
| Telephone No. with STD code: 0918369854318 |
Mobile: 8097903558 |
| E-mail: jshirodkar36@gmail.com |
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Academic Record - |
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| Class X: - |
Class XII: - |
| Year of Passing: 2009 |
Year of Passing: |
| Board: Maharashtra |
Board: |
| English %: 64 |
English %: |
| Aggregate Percentage: 64 |
Aggregate Percentage: |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
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| Chemistry |
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| Mathematics |
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| English |
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| Physics, Chemistry & Mathematics combined Percentage: |
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Diploma: |
Graduation: |
| Diploma Specialization: Electronics and Telecommunication Engineering |
Degree Specialization: Electronics Engineering |
| Name of Polytechnic: M H SABOO SIDDIK |
Name of College: K C COLLEGE OF ENGINEERING |
| Tel. No.: 23084881 |
Tel. No.: 25327100 |
| Email Id.: principle.unaided.mhssp@gmail.com |
Email Id.: info@kccemsr.edu.in |
| Board: MSBTE |
University: MUMBAI |
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| Year of Passing: 2014 |
Percentage: 63 |
Year of Passing: 2017 |
Percentage: 64 |
| Medium of Instruction: ENGLISH |
Medium of Instruction: ENGLISH |
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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 |
From |
To |
| VEDANG CELLULAR SERVICE PVT.LTD |
IBS ENGINEER |
24 Dec 2017 |
23 Dec 2018 |
| PLA ELECTRO APPLIANCES |
PURCHASE ENGINEER |
26 Dec 2018 |
15 Nov 2019 |
| SARASWAT BANK CO OP LTD |
JR.OFFICER |
25 Nov 2019 |
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| What are your hobbies ? CRICKET |
| What are your strengths ? DEDICATION |
| What are your weaknesses ? EASY TO TRUST |
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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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Date ________________ |
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