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 2022


Application Summary
 
Dossier ID: ETO2191091 Name: Saraiya Bhavik Ashokbhai
  Address: 2852 Behind Teachers society
Telephone No.: Mobile no: 9998637397
E-mail: bhavikk1107@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: 13630760541
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2191091 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 2022

Dossier ID: ETO2191091
 
Full Name (as per Passport) : Saraiya Bhavik Ashokbhai
Date of Birth (DD/MM/YY): 11 Jul 1995 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: U5843779 Date of Expiry:
Place of Issue: Surat Personal Identification Mark: No mark

(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.: 2852
Street /Lane: Behind Teachers society
Village / Post Office / Tehsil: Amalsad, Saribujrang
City / District: Navsari
State: Gujarat
PIN: 396310
Telephone No. with STD code: Mobile: 9998637397
E-mail: bhavikk1107@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2010 Year of Passing:
Board: Gujarat Board:
English %: 36 English %:
Aggregate Percentage: 60 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 Engineering Degree Specialization: Electrical Engineering
Name of Polytechnic: Vallabh budhi polytechnic Navsari Name of College: Gidc degree engineering college Abrama Navsari
Tel. No.: 9409749547 Tel. No.: 02637229040
Email Id.: Vbpollytechnic210@gmail.com Email Id.: gidcengcol@gmail.com
Board: Gujarat Technological University University: Gujarat Technological University 
Year of Joining: 2012
Year of Joining: 2015
Year of Passing: 2015 Percentage: 70 Year of Passing: 2019 Percentage: 61
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 -
Computer basic course

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Cooking, Reading books, Playing volly ball, Traveling
What are your strengths ? I like to accept any challenge and do it
What are your weaknesses ? no one
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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