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: ETO2167578 Name: Mohit Kumar
  Address: House No- 109 Sector- 8/B More, Koyla Depu
Telephone No.: Mobile no: 8002678464
E-mail: 027.mohitsharma@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 399838070
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167578 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: ETO2167578
 
Full Name (as per Passport) : Mohit Kumar
Date of Birth (DD/MM/YY): 27 Mar 1997 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: S6340320 Date of Expiry: 21 Mar 2029
Place of Issue: Bhubaneswar Odisha Personal Identification Mark: Birth Mark on Right Side of Jawline

(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.: House No- 109
Street /Lane: Sector- 8/B More, Koyla Depu
Village / Post Office / Tehsil: AT-Post- Sector-9/C, P.S- Harla Thana Sector-9
City / District: Bokaro Steel City
State: Jharkhand
PIN: 827009
Telephone No. with STD code: Mobile: 8002678464
E-mail: 027.mohitsharma@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2013 Year of Passing: 2015
Board: CBSE Board: CBSE
English %: 80 English %: 56
Aggregate Percentage: 84 Aggregate Percentage: 70
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 66 66
Chemistry 100 86 86
Mathematics 100 58 58
English 100 56 56
Physics, Chemistry & Mathematics combined Percentage: 70
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: Kalinga Institute Of Industrial Technology
Tel. No.: Tel. No.: 8114382202
Email Id.: Email Id.: registrar@kiit.ac.in
Board: University: KIIT University 
Year of Joining:
Year of Joining: 2015
Year of Passing: Percentage: Year of Passing: 2019 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 -

Work Experience, if any -

Name of the Firm Designation From To
Cognizant Technology & Solution Programmer Analyst 28 Dec 2019 21 Jan 2021
       
       
 
What are your hobbies ? Fitness Enthusiast
What are your strengths ? Learning From My Mistakes
What are your weaknesses ? 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