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: ETO2167465 Name: SHIRODKAR JAY RAJENDRA
  Address: 5,KRISHNA NIWAS N.M.JOSHI MARG
Telephone No.: Mobile no: 8097903558
E-mail: jshirodkar36@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 396135245
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2167465 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: ETO2167465
 
Full Name (as per Passport) : SHIRODKAR JAY RAJENDRA
Date of Birth (DD/MM/YY): 17 Dec 1993 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: S8278841 Date of Expiry: 18 Sep 2028
Place of Issue: Mumbai Personal Identification Mark: MOLE ON THE NECK

(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.: 5,KRISHNA NIWAS
Street /Lane: N.M.JOSHI MARG
Village / Post Office / Tehsil: CHINCHPOKLI
City / District: MUMBAI
State: Maharashtra
PIN: 400011
Telephone No. with STD code: 0918369854318 Mobile: 8097903558
E-mail: jshirodkar36@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2009 Year of Passing:
Board: Maharashtra Board:
English %: 64 English %:
Aggregate Percentage: 64 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 Engineering
Name of Polytechnic: M H SABOO SIDDIK Name of College: K C COLLEGE OF ENGINEERING
Tel. No.: 23084881 Tel. No.: 25327100
Email Id.: principle.unaided.mhssp@gmail.com Email Id.: info@kccemsr.edu.in
Board: MSBTE University: MUMBAIĀ 
Year of Joining: 2011
Year of Joining: 2014
Year of Passing: 2014 Percentage: 63 Year of Passing: 2017 Percentage: 64
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
VEDANG CELLULAR SERVICE PVT.LTD IBS ENGINEER 24 Dec 2017 23 Dec 2018
PLA ELECTRO APPLIANCES PURCHASE ENGINEER 26 Dec 2018 15 Nov 2019
SARASWAT BANK CO OP LTD JR.OFFICER 25 Nov 2019  
 
What are your hobbies ? CRICKET
What are your strengths ? DEDICATION
What are your weaknesses ? EASY TO TRUST
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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