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: ETO2190524 Name: Akshay
  Address: 12 gg
Telephone No.: Mobile no: 9860405145
E-mail: sanikajoshi82@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200.00 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 13548041071
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2190524 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: ETO2190524
 
Full Name (as per Passport) : Akshay
Date of Birth (DD/MM/YY): 24 Dec 1997 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: t

(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.: 12
Street /Lane: gg
Village / Post Office / Tehsil: dd
City / District: Pune
State: Maharashtra
PIN: 410507
Telephone No. with STD code: Mobile: 9860405145
E-mail: sanikajoshi82@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: CBSE Board: CBSE
English %: 76 English %: 81
Aggregate Percentage: 77 Aggregate Percentage: 85
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 82 82
Chemistry 100 75 75
Mathematics 100 80 80
English 100 76 76
Physics, Chemistry & Mathematics combined Percentage: 79
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical Engineering
Name of Polytechnic: Name of College: qq
Tel. No.: Tel. No.: 0486223353
Email Id.: Email Id.: info@tmi.tolani.edu
Board: University: Pune 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 ? dd
What are your strengths ? dd
What are your weaknesses ? dd
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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