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


Application Summary
 
Dossier ID: ETO2167556 Name: srivatsav mattaparthi
  Address: sri lakshmi apts2,s3 syamala nagar
Telephone No.: Mobile no: 8639904366
E-mail: vamsisrivatsav2425@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: -
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167556 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________

   
Date ________________ Date ________________
 

 

Please quote your dossier id and full name for any future correspondence
Please check that the following documents are accompanying this application :
  1. Three identical recent passport size photographs (including one attached on the form)
  2. Attested Copies of Class X, XII mark sheet, Age Proof
  3. Attested Copies of Graduation Semester/ Year wise Grade Sheet
  4. Attested Copies of Graduation Certificates
  5. Format of Annex-1 to be printed on college/institute letterhead and submitted along with application form
  6. CGPA / DGPA to percentage conversion letter (if applicable)
  7. Print the application form duly filled
  8. Send the hard copy of application form along with necessary documents to TMI, Induri
  9. Send filled application forms to Admissions Cell (ETO), Tolani Maritime Institute, Induri Village, Talegaon Chakan Road, Talegaon Dabhade, Pune, PIN- 410507

     
     

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: ETO2167556
 
Full Name (as per Passport) : srivatsav mattaparthi
Date of Birth (DD/MM/YY): 11 Jul 1996 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: P9554762 Date of Expiry: 30 Mar 2027
Place of Issue: visakhapatnam Personal Identification Mark: a mole on left 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.: sri lakshmi apts2,s3
Street /Lane: syamala nagar
Village / Post Office / Tehsil: rajahmundry
City / District: east godavari
State: Andhra Pradesh
PIN: 533103
Telephone No. with STD code: Mobile: 8639904366
E-mail: vamsisrivatsav2425@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing:
Board: Andhra Pradesh Board:
English %: 68 English %:
Aggregate Percentage: 84 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: Degree Specialization: Electronics and communication Engineering
Name of Polytechnic: Name of College: sagi ramakrishnam raju engineering college
Tel. No.: Tel. No.: 8816223330
Email Id.: Email Id.: principal@srkrec.ac.in
Board: University: Andhra university 
Year of Joining:
Year of Joining: 2013
Year of Passing: Percentage: Year of Passing: 2018 Percentage: 62
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 ? singing, playing shuttle badminton, reading books
What are your strengths ? i dont care about surrounding judgemental people when i do things to improve myself,
What are your weaknesses ? little sensitive guy, nervous about public speaking
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
Print Summary and Application Form