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: ETO2199559 Name: Potheeswaran
  Address: 1736 14 th sector
Telephone No.: Mobile no: 9080100904
E-mail: potherockers@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: 13879934991
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2199559 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: ETO2199559
 
Full Name (as per Passport) : Potheeswaran
Date of Birth (DD/MM/YY): 27 Oct 1998 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: V1813051 Date of Expiry:
Place of Issue: Chennai Personal Identification Mark: A mole on right finger

(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.: 1736
Street /Lane: 14 th sector
Village / Post Office / Tehsil: Kk nagar
City / District: Chennai
State: Tamil Nadu
PIN: 600078
Telephone No. with STD code: Mobile: 9080100904
E-mail: potherockers@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2014 Year of Passing: 2016
Board: Tamil Nadu Board: Tamil Nadu
English %: 86 English %: 81
Aggregate Percentage: 84 Aggregate Percentage: 66
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 60 60
Chemistry 100 66 66
Mathematics 100 49 49
English 100 81 81
Physics, Chemistry & Mathematics combined Percentage: 58.33
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: Panimalar institute of technology
Tel. No.: Tel. No.: 04426491113
Email Id.: Email Id.: info@pit.ac.in
Board: University: Anna University 
Year of Joining:
Year of Joining: 2016
Year of Passing: Percentage: Year of Passing: 2021 Percentage: 75
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 ? Playing games, reparing bikes
What are your strengths ? Positive thinking, smart worker,easily adaptable to any situation
What are your weaknesses ? I used to trust all people
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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