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: ETO2190959
 
Full Name (as per Passport) : Shubham Sachin Gudekar
Date of Birth (DD/MM/YY): 16 Aug 1995 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: R4078852 Date of Expiry:
Place of Issue: Mumbai Personal Identification Mark: Scar On Left Side Of Nose

(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.: Samartha Krupa Appt. Room No. 302
Street /Lane: Vani Ali
Village / Post Office / Tehsil: Chiplun
City / District: Chiplun
State: Maharashtra
PIN: 415605
Telephone No. with STD code: Mobile: 8087226422
E-mail: gudekarshubham@hotmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2013
Board: Maharashtra Board: Maharashtra
English %: 80 English %: 75
Aggregate Percentage: 91 Aggregate Percentage: 76
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 66 66
Chemistry 100 68 68
Mathematics 100 92 92
English 100 75 75
Physics, Chemistry & Mathematics combined Percentage: 75.33
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical Engineering
Name of Polytechnic: Name of College: FAMT Rantnagiri
Tel. No.: Tel. No.: 7559463770
Email Id.: Email Id.: admin@famt.ac.in
Board: University: Mumbai University 
Year of Joining:
Year of Joining: 2013
Year of Passing: Percentage: Year of Passing: 2017 Percentage: 60
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 -
Diploma In Automatiion Course From Sage Automation

Work Experience, if any -

Name of the Firm Designation From To
Ashida Electronics Pvt. Ltd. Thane Project Engineer    
       
       
 
What are your hobbies ? Chess
What are your strengths ? Hardworking
What are your weaknesses ? Overthinking
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________