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: ETO2167735
 
Full Name (as per Passport) : Rajat Kumar
Date of Birth (DD/MM/YY): 25 Apr 1999 Nationality: INDIA
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Jamshedpur Personal Identification Mark: Black spot in the right elbow

(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.: E-109,Ashiyana Enclave,KrishnaGiri,Dimna chowk,Mango,Jamshedpur
Street /Lane: Dimna Chowk ,Ashiyana Enclave
Village / Post Office / Tehsil: Bistupur
City / District: Jamshedpur
State: Jharkhand
PIN: 831012
Telephone No. with STD code: Mobile: 7004031783
E-mail: rajatkumar.kumar856@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2015 Year of Passing: 2017
Board: CBSE Board: CBSE
English %: 85 English %: 85
Aggregate Percentage: 87 Aggregate Percentage: 80
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 82 82
Chemistry 100 90 90
Mathematics 100 72 72
English 100 85 85
Physics, Chemistry & Mathematics combined Percentage: 81.33
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electronics and Telecommunication Engineering
Name of Polytechnic: Name of College: KIIT Deemed to be University
Tel. No.: Tel. No.: 7004031783
Email Id.: Email Id.: 1704283@kiit.ac.in
Board: University: KIIT 
Year of Joining:
Year of Joining: 2017
Year of Passing: Percentage: Year of Passing: 2021 Percentage: 79
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 ? Travelling,Biking,Day trading
What are your strengths ? Multitasking,Sports
What are your weaknesses ? Staying idle
 
 
Declaration

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

Signature of Candidate

 

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Date ________________