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: ETO2198696 Name: Vikas Kumar Singh
  Address: 100 DEURAVA GADDI TOLA
Telephone No.: Mobile no: 8889994134
E-mail: vikaskumarsingh2k@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: 13852240787
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2198696 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: ETO2198696
 
Full Name (as per Passport) : Vikas Kumar Singh
Date of Birth (DD/MM/YY): 18 Mar 1998 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Z5912574 Date of Expiry:
Place of Issue: PATNA Personal Identification Mark: MOLE ON RIGHT CHEEK

(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.: 100
Street /Lane: DEURAVA GADDI TOLA
Village / Post Office / Tehsil: SANGWADIH, BODHACHHAPAR, KUCHAIKOTE
City / District: GOPALGANJ
State: Bihar
PIN: 841503
Telephone No. with STD code: Mobile: 8889994134
E-mail: vikaskumarsingh2k@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2013
Board: Uttar Pradesh Board: Uttar Pradesh
English %: 75 English %: 68
Aggregate Percentage: 61 Aggregate Percentage: 69
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 71 71
Chemistry 100 63 63
Mathematics 100 70 70
English 100 68 68
Physics, Chemistry & Mathematics combined Percentage: 68
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: ORIENTAL COLLEGE OF TECHNOLOGY
Tel. No.: Tel. No.: 07552529026
Email Id.: Email Id.: oistbpl@oriental.ac.in
Board: University: RAGIV GANDHI PROUDYOGIKI VISHWAVIDYALAYA 
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2021 Percentage: 67
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 ? LEARN NEW THINGS ABOUT TECHNOLOGY, READING
What are your strengths ? FAST LEARNER
What are your weaknesses ? IMOTION
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
Print Summary and Application Form