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: ETO2167733
 
Full Name (as per Passport) : shalu shajan
Date of Birth (DD/MM/YY): 17 Jul 1995 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: A Black mole under nose

(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.: Mekkattukulam house
Street /Lane: kanippayyur p.o
Village / Post Office / Tehsil: kunnamkulam
City / District: Thrissur
State: Kerala
PIN: 680517
Telephone No. with STD code: Mobile: 9544741577
E-mail: shalushajan93@gmail.com  
 

Academic Record -

  
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2013
Board: Kerala Board: Kerala
English %: 90 English %: 88
Aggregate Percentage: 88 Aggregate Percentage: 94
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 200 190 95
Chemistry 200 197 98.5
Mathematics 200 184 92
English 100 88 88
Physics, Chemistry & Mathematics combined Percentage: 95.17
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electronics and communication Engineering
Name of Polytechnic: Name of College: GEC thrissur
Tel. No.: Tel. No.: 04872334590
Email Id.: Email Id.: principal@gectcr.ac.in
Board: University: university of calicut 
Year of Joining:
Year of Joining: 2014
Year of Passing: Percentage: Year of Passing: 2018 Percentage: 66
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 cricket and football, travelling
What are your strengths ? Self driven and flexible
What are your weaknesses ? public speaking
 
 
Declaration

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

Signature of Candidate
 

___________________
 

Date ________________