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: ETO2167537
 
Full Name (as per Passport) : YADU KRISHNAN T
Date of Birth (DD/MM/YY): 18 Apr 1998 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Palakkad Personal Identification Mark: Butn matk 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.: KANJIKODE PALAKKAD
Street /Lane: KTC
Village / Post Office / Tehsil: KANJIKODE
City / District: PalakkadPALAKKAD
State: Kerala
PIN: 678621
Telephone No. with STD code: Mobile: 8921951684
E-mail: yadutyttrium25@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing:
Board: CBSE Board:
English %: 94 English %:
Aggregate Percentage: 94 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: Degree Specialization: Electronics and Instrumentation
Name of Polytechnic: Name of College: COLLEGE OF ENGINEERING VADAKARA
Tel. No.: Tel. No.: 914962536125
Email Id.: Email Id.: cevcape@cev.ac.in
Board: University: KALAM TECHONOLOGICAL UNIVERSITY 
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2020 Percentage: 68
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 ? TAKING PHOTOS
What are your strengths ? TRAVEL SHORT DISTANCES
What are your weaknesses ? HEIGHT
 
 
Declaration

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

Signature of Candidate

 

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Date ________________