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: ETO2199929 Name: SHITANSHU PRATAP MISHRA
  Address: q 695 D,kawabagh railway colony
Telephone No.: Mobile no: 8595622775
E-mail: 1096shitanshu@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: 13894275933
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID ETO2199929 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: ETO2199929
 
Full Name (as per Passport) : SHITANSHU PRATAP MISHRA
Date of Birth (DD/MM/YY): 10 Feb 1996 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Passport No.: Date of Expiry:
Place of Issue: Personal Identification Mark: cut mark on right forehead

(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.: q 695 D,kawabagh railway
Street /Lane: colony
Village / Post Office / Tehsil: railway post office
City / District: gorakhpur
State: Uttar Pradesh
PIN: 273012
Telephone No. with STD code: Mobile: 8595622775
E-mail: 1096shitanshu@gmail.com  
 

Academic Record -

 
Class X: - Class XII: -
Year of Passing: 2011 Year of Passing: 2014
Board: CBSE Board: Uttar Pradesh
English %: 76 English %: 77
Aggregate Percentage: 74 Aggregate Percentage: 75
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 70 70
Chemistry 100 84 84
Mathematics 100 78 78
English 100 77 77
Physics, Chemistry & Mathematics combined Percentage: 77.33
   
   

Diploma:

Graduation:
Diploma Specialization: Degree Specialization: Electrical and Electronics Engineering
Name of Polytechnic: Name of College: inderprastha engineering college
Tel. No.: Tel. No.: 1800120802000
Email Id.: Email Id.: admission@ipec.org.in
Board: University: Dr. A.P.J. abdul kalam technical university 
Year of Joining:
Year of Joining: 2014
Year of Passing: Percentage: Year of Passing: 2018 Percentage: 66
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 -
PGDM- embedded systems developer, national award in scouting

Work Experience, if any -

Name of the Firm Designation From To
       
       
       
 
What are your hobbies ? reading books,travelling,
What are your strengths ? Enthusiasm,Trustworthiness,Creativity.
What are your weaknesses ? lazy,foodie,
 
 
Declaration

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

Signature of Candidate

 

___________________

 

Date ________________

 
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