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: ETO2199067
 
Full Name (as per Passport) : Zargham Haider
Date of Birth (DD/MM/YY): 25 Sep 1999 Nationality: India
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Lucknow Personal Identification Mark: Eyebrow cut

(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.: Sikrauri, kakori, lucknow
Street /Lane: Ismat colony near Haji colony ,Dubagga ,Sitapura bypass ,Lucknow
Village / Post Office / Tehsil: Sikrauri, kakori
City / District: Lucknow
State: Uttar Pradesh
PIN: 226101
Telephone No. with STD code: Mobile: 9369686563
E-mail: zarghamh10@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2015 Year of Passing: 2017
Board: Uttar Pradesh Board: Uttar Pradesh
English %: 88 English %: 63
Aggregate Percentage: 76 Aggregate Percentage: 66
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 81 81
Chemistry 100 61 61
Mathematics 100 56 56
English 100 66 66
Physics, Chemistry & Mathematics combined Percentage: 66
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical Engineering
Name of Polytechnic: Name of College: Bansal Institute of engineering and technology
Tel. No.: Tel. No.: 9369686563
Email Id.: Email Id.: zarghamh10@gmail.com
Board: University: Abdul kalam Technical University 
Year of Joining:
Year of Joining: 2017
Year of Passing: Percentage: Year of Passing: 2021 Percentage: 71
Medium of Instruction: Medium of Instruction: English medium

Note: Diploma/Degree courses must be recognised by any State or Central Government or the AICTE.

Other Qualification, if any -
No

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Playing cricket, football, and listening music , traveling
What are your strengths ? Working with team or enjoying a work in good atmosphere
What are your weaknesses ? Frank and trusted
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________