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: ETO2199130
 
Full Name (as per Passport) : Potnuru Venkata Ramana Murthy
Date of Birth (DD/MM/YY): 18 Aug 1999 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: U837713B Date of Expiry:
Place of Issue: Srikakulam Personal Identification Mark: A mole on the 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.: 297
Street /Lane: Hudco colony
Village / Post Office / Tehsil: Srikakulam
City / District: Srikakulam
State: Andhra Pradesh
PIN: 532001
Telephone No. with STD code: 0894508916912123 Mobile: 7013760278
E-mail: venkattendulkar00@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing:
Board: Andhra Pradesh Board:
English %: 50 English %:
Aggregate Percentage: 83 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: Electrical and Electronics Engineering Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Sanketika polytechnic college Name of College: Baba institute of technology and sciences
Tel. No.: 089142223366 Tel. No.: 0891242428
Email Id.: sanketikapolytechnic@gmail.com Email Id.: bitsexamcellinfo@gmail.com
Board: State board of technical education and training University: Jawaharlal Nehru technological University of kakinada 
Year of Joining: 2014
Year of Joining: 2017
Year of Passing: 2017 Percentage: 69 Year of Passing: 2021 Percentage: 66
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 -
No

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? Playing cricket, visiting new places
What are your strengths ? Confident and determined
What are your weaknesses ? Over thinking
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________