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: ETO2167533
 
Full Name (as per Passport) : Vishwanath
Date of Birth (DD/MM/YY): 29 Jan 2003 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: Not at all

(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.: M-33A Sector-23 Sanjay Nagar Ghaziabad
Street /Lane: Near H.P.L
Village / Post Office / Tehsil: Kavi nagar
City / District: Ghaziabad
State: Uttar Pradesh
PIN: 201002
Telephone No. with STD code: Mobile: 9953901078
E-mail: negivishwanath@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2018 Year of Passing:
Board: CBSE Board:
English %: 60 English %:
Aggregate Percentage: 42 Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
English
Physics, Chemistry & Mathematics combined Percentage:
   
   

Diploma:

Graduation:
Diploma Specialization: Electrical Engineering Degree Specialization:
Name of Polytechnic: Suresh deep polytechnic Name of College:
Tel. No.: 07840090830 Tel. No.:
Email Id.: registrar@gmail.com Email Id.:
Board: BTEUP University:  
Year of Joining: 2018
Year of Joining:
Year of Passing: 2021 Percentage: 60 Year of Passing: Percentage:
Medium of Instruction: English Medium of Instruction:

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 ? Play cricket, football , singing
What are your strengths ? Good communication skill , problem solving, love to do Hard work
What are your weaknesses ? Patience , Taking too many risks.
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________