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: ETO2167529
 
Full Name (as per Passport) : ROSHAN KUMAR
Date of Birth (DD/MM/YY): 30 Aug 1999 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: MOLE ON FOREHEAD

(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.: CIVIL LINE ,VIPRA NAGAR
Street /Lane: WARD NO 18
Village / Post Office / Tehsil: BUXAR
City / District: BUXAR
State: Bihar
PIN: 802101
Telephone No. with STD code: Mobile: 7004155640
E-mail: kroshan561@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: CBSE Board: CBSE
English %: 76 English %: 76
Aggregate Percentage: 77 Aggregate Percentage: 72
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 65 65
Chemistry 100 70 70
Mathematics 100 53 53
English 100 76 76
Physics, Chemistry & Mathematics combined Percentage: 62.67
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electronics and communication Engineering
Name of Polytechnic: Name of College: RJIT BSF ACADEMY
Tel. No.: Tel. No.: 7524274319
Email Id.: Email Id.: rjit_bsft@yahoo.com
Board: University: RGPV BHOPALĀ 
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2020 Percentage: 72
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 ? Singing, watching political/world affairs
What are your strengths ? Easily accommodate in any new environment , very socialized , helpful
What are your weaknesses ? Do not take bath regularly , not so much fashioned-oriented
 
 
Declaration

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

Signature of Candidate

 

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Date ________________