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: ETO2167743 Name: MALODE SIDDHANT BAPU
  Address: MANASI COLLECTION MAIN ROAD
Telephone No.: Mobile no: 8446844398
E-mail: siddhantmalode@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: 403322776
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167743 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: ETO2167743
 
Full Name (as per Passport) : MALODE SIDDHANT BAPU
Date of Birth (DD/MM/YY): 04 Aug 1995 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: U7214105 Date of Expiry: 27 Dec 2030
Place of Issue: MUMBAI Personal Identification Mark: MARK ON RIGHT CHEEKS

(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.: MANASI COLLECTION
Street /Lane: MAIN ROAD
Village / Post Office / Tehsil: ADGAON
City / District: NASHIK
State: Maharashtra
PIN: 422003
Telephone No. with STD code: Mobile: 8446844398
E-mail: siddhantmalode@gmail.com  
 

Academic Record -

  
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2019
Board: Maharashtra Board: Maharashtra
English %: 55 English %: 51
Aggregate Percentage: 69 Aggregate Percentage: 66
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 60 60
Chemistry 100 60 60
Mathematics 100 87 87
English 100 51 51
Physics, Chemistry & Mathematics combined Percentage: 69
   
   

Diploma:

Graduation:
Diploma Specialization: Electronics and Telecommunication Engineering Degree Specialization: Electronics and Telecommunication Engineering
Name of Polytechnic: K K WAGH POLYTECHNIC Name of College: METS BHUJBAL KNHOWLEDGE CITY
Tel. No.: 02532517005 Tel. No.: 02532303515
Email Id.: principal-poly@kkwagh.edu.in Email Id.: enquiries@bkc.met.edu
Board: MSBTE University: SPPU 
Year of Joining: 2011
Year of Joining: 2017
Year of Passing: 2014 Percentage: 54 Year of Passing: 2021 Percentage: 63
Medium of Instruction: ENGLISH Medium of Instruction: ENGLISH

Note: Diploma/Degree courses must be recognised by any State or Central Government or the AICTE.
Other Qualification, if any -
PLC SCADA AUTOMATION

Work Experience, if any -
Name of the Firm Designation From To
MACK PHARMATECH PVT.LTD NASHIK SERVICE ENGINEER 05 Apr 2014 05 Dec 2015
KVN NAIK POLYTECHNIC NASHIK TECHNICAL ASSISTANT 10 Feb 2016 07 Aug 2017
       
 
What are your hobbies ? WATCHING T.V
What are your strengths ? SELF MOTIVATED AND HARD WORKING WITH POSITIVE ATTITUDE TOWARDS MY LIFE
What are your weaknesses ? I CAN NOT COMFORT UNTIL I FINISH THE WORK WITHIN TIME
 
 
Declaration

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

Signature of Candidate
 

___________________
 

Date ________________
 
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