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: ETO2167511
 
Full Name (as per Passport) : NIKHIL PRABHAKAR
Date of Birth (DD/MM/YY): 16 Nov 1995 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: A MOLE ON LEFT HAND

(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.: AT-MEENA BAZAR
Street /Lane: MADHUPUR
Village / Post Office / Tehsil: MADHUPUR
City / District: DEOGHAR
State: Jharkhand
PIN: 815353
Telephone No. with STD code: Mobile: 7223068748
E-mail: nikhilprabhakar95@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2013
Board: CBSE Board: Bihar
English %: 70 English %: 46
Aggregate Percentage: 78 Aggregate Percentage: 59
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 72 72
Chemistry 100 57 57
Mathematics 100 60 60
English 100 46 46
Physics, Chemistry & Mathematics combined Percentage: 63
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical Engineering
Name of Polytechnic: Name of College: RADHARAMAN GROUP OF INSTITUTION
Tel. No.: Tel. No.: 2678891
Email Id.: Email Id.: info@radharamanbhopal.com
Board: University: RAJIV GANDHI PROUDYOGIKI VISHWAVIDIYALAYA BHOPALĀ 
Year of Joining:
Year of Joining: 2014
Year of Passing: Percentage: Year of Passing: 2018 Percentage: 69
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 ? STUDIES
What are your strengths ? COMMUNICATION SKILLS
What are your weaknesses ? HELP ANY PERSON WITHOUT UNDERSTANDING
 
 
Declaration

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

Signature of Candidate

 

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Date ________________