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 2022


Application Summary
 
Dossier ID: ETO2167519 Name: Jagadesan
  Address: 1/199, old no 12 Kaliamman kovil Street
Telephone No.: Mobile no: 7708377695
E-mail: jagadesan222@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 ETO2167519 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 2022

Dossier ID: ETO2167519
 
Full Name (as per Passport) : Jagadesan
Date of Birth (DD/MM/YY): 20 Dec 1998 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: T3552287 Date of Expiry: 31 Mar 2029
Place of Issue: Chennai Personal Identification Mark: Mole in left pointing finger

(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.: 1/199, old no 12
Street /Lane: Kaliamman kovil Street
Village / Post Office / Tehsil: Karapakkam
City / District: Chennai
State: Tamil Nadu
PIN: 600097
Telephone No. with STD code: Mobile: 7708377695
E-mail: jagadesan222@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: Tamil Nadu Board: Tamil Nadu
English %: 81 English %: 83
Aggregate Percentage: 79 Aggregate Percentage: 61
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 59 59
Chemistry 100 69 69
Mathematics 100 45 45
English 100 83 83
Physics, Chemistry & Mathematics combined Percentage: 57.67
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: Agni college of technology
Tel. No.: Tel. No.: 0446709441
Email Id.: Email Id.: mail@act.edu.in
Board: University: Anna university  
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2020 Percentage: 73
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 -
Plc programming

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Riding
What are your strengths ? Open minded, analytical
What are your weaknesses ? Lazy
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
Print Summary and Application Form