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: ETO2196448 Name: DEEP MALLICK
  Address: NEAR JHANTU KALI BARI RABINDRAPALLY
Telephone No.: Mobile no: 6289461389
E-mail: mallickdeep709@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: 13800934894
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2196448 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: ETO2196448
 
Full Name (as per Passport) : DEEP MALLICK
Date of Birth (DD/MM/YY): 11 Jun 1995 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: M3972320 Date of Expiry:
Place of Issue: KOLKATA Personal Identification Mark: DARK MOLE BELOW THE RIGHT EYES

(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.: NEAR JHANTU KALI BARI
Street /Lane: RABINDRAPALLY
Village / Post Office / Tehsil: NONA CHANDANPUKUR PO
City / District: KOLKATA
State: West Bengal
PIN: 700122
Telephone No. with STD code: 0339830830887 Mobile: 6289461389
E-mail: mallickdeep709@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing:
Board: CBSE Board:
English %: 70 English %:
Aggregate Percentage: 61 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: Electronics and communication Engineering Degree Specialization: Electronics and communication Engineering
Name of Polytechnic: TECHNO INDIA UNIVERSITY Name of College: TECHNO INDIA UNIVERSITY
Tel. No.: 9836544419 Tel. No.: 9836544417
Email Id.: info@techindiauniversity.ac.in Email Id.: info@techindiauniversity.ac.in
Board: UGC University: UGC 
Year of Joining: 2015
Year of Joining: 2018
Year of Passing: 2018 Percentage: 83 Year of Passing: 2021 Percentage: 88
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 -

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? SINGING
What are your strengths ? SELF MOTIVATED
What are your weaknesses ? SELF CRITICISM
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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