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: ETO2167624 Name: Ankit Gusain
  Address: 112 SANGAM APARTMENT POCKET 24 SECTOR 24
Telephone No.: Mobile no: 9999473986
E-mail: ANKIT6137922@OUTLOOK.COM  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 401126490
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167624 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: ETO2167624
 
Full Name (as per Passport) : Ankit Gusain
Date of Birth (DD/MM/YY): 07 Jun 1994 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Married
Passport No.: S2458785 Date of Expiry: 10 Aug 2028
Place of Issue: DELHI Personal Identification Mark: MOLE IN RIGHT EYE

(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.: 112 SANGAM APARTMENT
Street /Lane: POCKET 24 SECTOR 24
Village / Post Office / Tehsil: ROHINI
City / District: NEW DELHI
State: Delhi
PIN: 110085
Telephone No. with STD code: Mobile: 9999473986
E-mail: ANKIT6137922@OUTLOOK.COM  
 

Academic Record -

  
Class X: - Class XII: -
Year of Passing: 2010 Year of Passing: 2012
Board: CBSE Board: CBSE
English %: 57 English %: 72
Aggregate Percentage: 70 Aggregate Percentage: 62
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 60 60
Chemistry 100 63 63
Mathematics 100 53 53
English 100 72 72
Physics, Chemistry & Mathematics combined Percentage: 58.67
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electronics and Telecommunication Engineering
Name of Polytechnic: Name of College: CHITKARA SCHOOL OF ENGINEERING
Tel. No.: Tel. No.: 911795661011
Email Id.: Email Id.: info@chitkarauniversity.edu.in
Board: University: CHITKARA UNIVERSITY HIMACHAL PRADESH 
Year of Joining:
Year of Joining: 2012
Year of Passing: Percentage: Year of Passing: 2017 Percentage: 61
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
DISH TV INIDA PVT LIMITED ASSISTANT ENGINEER- TECHNICAL MAINTAINANCE 01 May 2017 24 Dec 2018
PLAYBOX TECHNOLOGY PVT LIMITED ENGINEER 25 Dec 2018 01 Sep 2019
ASTRA MICROWAVE PVT LIMITED ENGINEER 15 Jun 2020  
 
What are your hobbies ? COOKING, SOLVING PUZZELES, PLAYING CASUAL OUTDOOR SPORTS
What are your strengths ? NATURAL CUROSITY, TEAM PLAYER, CONSTANT LEARNER
What are your weaknesses ? DIFFICULTY SHARING OR OPENING UP IN GROUPS AT FIRST
 
 
Declaration

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

Signature of Candidate
 

___________________
 

Date ________________
 
Print Summary and Application Form