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: ETO2167531 Name: Dummu Baburao
  Address: 2-183 Pillavariveedhi
Telephone No.: Mobile no: 9963436172
E-mail: dummubaburao@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 ETO2167531 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: ETO2167531
 
Full Name (as per Passport) : Dummu Baburao
Date of Birth (DD/MM/YY): 03 Apr 1999 Nationality: INDIA
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: SRIKAKULAM Personal Identification Mark: A mole on the upper lip

(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.: 2-183
Street /Lane: Pillavariveedhi
Village / Post Office / Tehsil: Dibbavanipeta
City / District: SRIKAKULAM
State: Andhra Pradesh
PIN: 532218
Telephone No. with STD code: Mobile: 9963436172
E-mail: dummubaburao@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing:
Board: Andhra Pradesh Board:
English %: 70 English %:
Aggregate Percentage: 85 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: Electrical and Electronics Engineering Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Government polytechnicsrikakulam Name of College: Sri sivani collage engineering
Tel. No.: 9912342008 Tel. No.: 9491840633
Email Id.: gptsrikakulam@gmail.com Email Id.: info@srisivani.com
Board: SBTET University: JNTUKĀ 
Year of Joining: 2014
Year of Joining: 2017
Year of Passing: 2017 Percentage: 73 Year of Passing: 2020 Percentage: 79
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 ? Reading news paper
What are your strengths ? Self -control
What are your weaknesses ? Public speaking
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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