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: ETO2167519
 
Full Name (as per Passport) : Jagadesan
Date of Birth (DD/MM/YY): 20 Dec 1998 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: T3552287 Date of Expiry: 31 Mar 2029
Place of Issue: Chennai Personal Identification Mark: Mole in left pointing finger

(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.: 1/199, old no 12
Street /Lane: Kaliamman kovil Street
Village / Post Office / Tehsil: Karapakkam
City / District: Chennai
State: Tamil Nadu
PIN: 600097
Telephone No. with STD code: Mobile: 7708377695
E-mail: jagadesan222@gmail.com  
 

Academic Record -

  
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: Tamil Nadu Board: Tamil Nadu
English %: 81 English %: 83
Aggregate Percentage: 79 Aggregate Percentage: 61
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 59 59
Chemistry 100 69 69
Mathematics 100 45 45
English 100 83 83
Physics, Chemistry & Mathematics combined Percentage: 57.67
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: Agni college of technology
Tel. No.: Tel. No.: 0446709441
Email Id.: Email Id.: mail@act.edu.in
Board: University: Anna university  
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2020 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 -
Plc programming

Work Experience, if any -
Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Riding
What are your strengths ? Open minded, analytical
What are your weaknesses ? Lazy
 
 
Declaration

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

Signature of Candidate
 

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Date ________________