Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: admissions@tmi.tolani.edu, Web: www.tolani.edu
Electro-Technical Officers Course
(Pre-sea Training & Certification for Merchant Ships)

APPLICATION FOR ADMISSION - October 2021


Application Summary
 
Dossier ID: ETO2167350 Name: Patil Vaishnavi Avinash
  Address: 65 Kumbhar Gali kembali
Telephone No.: Mobile no: 9552050078
E-mail: patilvaishu285@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: -
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167350 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 keep a copy of the form for your reference for communicating with the Institute.
Institute will communicate with you once the form is submitted and online payment is done successfully. Please keep all your academic certificates & Annex-I ready with you.

     
     

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: admissions@tmi.tolani.edu, Web: www.tolani.edu
Electro-Technical Officers Course
(Pre-sea Training & Certification for Merchant Ships)

APPLICATION FOR ADMISSION - October 2021

Dossier ID: ETO2167350
 
Full Name (as per Passport) : Patil Vaishnavi Avinash
Date of Birth (DD/MM/YY): 25 Jul 1997 Nationality: Indian
Gender (M/F): Female Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: Mole on right 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.: 65
Street /Lane: Kumbhar Gali kembali
Village / Post Office / Tehsil: Kagal
City / District: Kolhapur
State: Maharashtra
PIN: 416221
Telephone No. with STD code: Mobile: 9552050078
E-mail: patilvaishu285@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2013 Year of Passing:
Board: Maharashtra Board:
English %: 76 English %:
Aggregate Percentage: 84 Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
English
Physics, Chemistry & Mathematics combined Percentage:
   
   

Diploma:

Graduation:
Diploma Specialization: Electronics and Telecommunication Engineering Degree Specialization: Electronics and Telecommunication Engineering
Name of Polytechnic: Bapuji Salunke institute of engineering and technology Name of College: Sanjay ghodawat group of institutions
Tel. No.: 07038657473 Tel. No.: 02302463700
Email Id.: bsieat@gmail.com Email Id.: director@sginstitute.in
Board: MSBTE University: Shivaji University 
Year of Joining: 2014
Year of Joining: 2017
Year of Passing: 2017 Percentage: 62 Year of Passing: 2020 Percentage: 72
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 -

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Traveling, playing guitar, swimming, sports, dance
What are your strengths ? Friendly nature, Hard working and honest, ready to learn new things
What are your weaknesses ? Doing shopping
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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