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: ETO2167641 Name: SHASHANK
  Address: 101/147 Shalimar Garden , Extension 1, Rose park
Telephone No.: Mobile no: 8527860262
E-mail: snn.165@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1212.73 (Includes Convenience fee of ₹ 12.73 ) DD Number: -
Issuing Bank: - Transaction Id: 401282546
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167641 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: ETO2167641
 
Full Name (as per Passport) : SHASHANK
Date of Birth (DD/MM/YY): 19 May 1995 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: U4120725 Date of Expiry: 14 Sep 2030
Place of Issue: GHAZIABAD Personal Identification Mark: Small cut near my 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.: 101/147
Street /Lane: Shalimar Garden , Extension 1, Rose park
Village / Post Office / Tehsil: Sahibabad
City / District: Ghaziabad
State: Uttar Pradesh
PIN: 201005
Telephone No. with STD code: Mobile: 8527860262
E-mail: snn.165@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2013
Board: CBSE Board: CBSE
English %: 76 English %: 72
Aggregate Percentage: 80 Aggregate Percentage: 68
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 62 62
Chemistry 100 66 66
Mathematics 100 78 78
English 100 72 72
Physics, Chemistry & Mathematics combined Percentage: 68.67
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: Krishna Engineering College
Tel. No.: Tel. No.: 01202657731
Email Id.: Email Id.: director@krishnacollege.ac.in
Board: University: AKTUĀ 
Year of Joining:
Year of Joining: 2013
Year of Passing: Percentage: Year of Passing: 2017 Percentage: 68
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 ? Playing Games, Being Positive
What are your strengths ? Passionate about my work
What are your weaknesses ? Sometimes Short Tempered
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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