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: ETO2191151 Name: RAKESH R
  Address: 195 B 1 BLOCK 6TH MAIN STREET
Telephone No.: Mobile no: 6383161032
E-mail: rakeshrakesh06189@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: 13614273333
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2191151 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: ETO2191151
 
Full Name (as per Passport) : RAKESH R
Date of Birth (DD/MM/YY): 14 Jun 1998 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: V0575758 Date of Expiry:
Place of Issue: CHENNAI Personal Identification Mark: A SCAR ON THE LEFT EAR

(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.: 195 B 1 BLOCK
Street /Lane: 6TH MAIN STREET
Village / Post Office / Tehsil: R H CENTER INDIRA NAGAR
City / District: NEYVELI CUDDALORE
State: Tamil Nadu
PIN: 607801
Telephone No. with STD code: Mobile: 6383161032
E-mail: rakeshrakesh06189@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: Tamil Nadu Board: Tamil Nadu
English %: 77 English %: 89
Aggregate Percentage: 82 Aggregate Percentage: 75
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 79 79
Chemistry 100 76 76
Mathematics 100 68 68
English 100 89 89
Physics, Chemistry & Mathematics combined Percentage: 74.33
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: ANNA UNIVERSITY PANRUTI CAMPUS
Tel. No.: Tel. No.: 04142241000
Email Id.: Email Id.: office@ucep.edu.in
Board: University: ANNA UNIVERSITY 
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2020 Percentage: 65
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 ? PLAYING GAMES
What are your strengths ? MY ARE MY ATTITUDE THAT I LIKE TO TAKE CHALLENGES AND CAN DO IT
What are your weaknesses ? I DON T LIKE TO SAY MY WEAKNESS THAT I LIKE TO SAY SCOPE OF IMPROVEMENT THAT BELIEVE IN MY SELF AN MY HARDWORK
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
Print Summary and Application Form