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: ETO2198469
 
Full Name (as per Passport) : varadhi Nagesh
Date of Birth (DD/MM/YY): 15 Aug 1994 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: A mole on right hand

(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.: 2-110
Street /Lane: pedda veedhi
Village / Post Office / Tehsil: gullavani peta / belamara post
City / District: srikakulam
State: Andhra Pradesh
PIN: 532430
Telephone No. with STD code: Mobile: 8074790116
E-mail: varadhinagesh@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing:
Board: Andhra Pradesh Board:
English %: 50 English %:
Aggregate Percentage: 75 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: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: SISTAM college
Tel. No.: Tel. No.: 09666123133
Email Id.: Email Id.: sistam51@gmail.com
Board: University: JNTUKĀ 
Year of Joining:
Year of Joining: 2013
Year of Passing: Percentage: Year of Passing: 2017 Percentage: 64
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 ? travelling , browsing net , watching movies
What are your strengths ? postive attitude , patience , dedication
What are your weaknesses ? insecure
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________