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: ETO2167606 Name: imran khan
  Address: mukundapur jasteghari road
Telephone No.: Mobile no: 9733341042
E-mail: imrankhan.ee15@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 402815087
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167606 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: ETO2167606
 
Full Name (as per Passport) : imran khan
Date of Birth (DD/MM/YY): 25 Jul 1997 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: a mole in 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.: mukundapur
Street /Lane: jasteghari road
Village / Post Office / Tehsil: mukundapur
City / District: purba medinipur
State: West Bengal
PIN: 721446
Telephone No. with STD code: Mobile: 9733341042
E-mail: imrankhan.ee15@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2013 Year of Passing: 2015
Board: West Bengal Board: West Bengal
English %: 51 English %: 74
Aggregate Percentage: 71 Aggregate Percentage: 70
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 68 68
Chemistry 100 63 63
Mathematics 100 76 76
English 100 74 74
Physics, Chemistry & Mathematics combined Percentage: 69
   
   

Diploma:

Graduation:
Diploma Specialization: Electrical Engineering Degree Specialization:
Name of Polytechnic: global institute of science and technology Name of College:
Tel. No.: 9564733330 Tel. No.:
Email Id.: info@besonline.in Email Id.:
Board: westbengal state council of technical education University:  
Year of Joining: 2015
Year of Joining:
Year of Passing: 2018 Percentage: 73 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 -
4 month automation course in plc,scada,and hmi

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? love to play cricket,cooking,reading
What are your strengths ? incination to learning new thing,love to take responsibilities
What are your weaknesses ? introvert type of guy ,shy to talk with any random guy
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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