Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: admissions@tmi.tolani.edu, Web: www.tolani.edu
Lateral Entry - B.Tech (Marine Engineering) 2021


Application Summary: Lateral Entry - B.Tech (Marine Engineering)
 
Dossier ID: LTE2188197 Name: Rohan Ernesto Sequeira Vaz
  Address: H.s No 50c -1 ,Near ST. Roque Chapel OPP.DR Rachel Dental Clinic Senaulim - Verna ,Goa
Telephone No.: Mobile no: 7262074172
E-mail: rohansvaz14@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1225.74 (Includes Convenience fee of ₹ 25.74 )
Transaction Id: 440717932
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2188197 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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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.
Note: Please remember to login and fill in your 3rd year diploma marks (if cleared in 2021) in order to complete your application form.
 

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: admissions@tmi.tolani.edu, Web: www.tolani.edu
Lateral Entry - B.Tech (Marine Engineering)

APPLICATION FOR ADMISSION - 2021

 
Dossier ID: LTE2188197
 
Applicant's Personal Information:
 
Full Name as on Diploma Marksheet/Pass Certificate: Rohan Ernesto Sequeira Vaz
Mother's Name: Ligia Maria Sheila Sequeira Vaz  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 14 Dec 2001 Name as per passport:Rohan Ernesto Sequeira Vaz
Passport No.: R6742995 Date of Expiry: 19 Apr 2028
Place of Issue: Panaji Nationality: Indian

((Note: If you do not have passport, you may apply for it as early as possible as passport is mandatory at the time of admission.)

Place of Birth: Panaji Personal Identification Mark: Birth Mark near left eyebrow
Blood Group: A + Address for Communication: H.s No 50c -1 ,Near ST. Roque Chapel OPP.DR Rachel Dental Clinic Senaulim - Verna ,Goa
State: Goa Country: India
Pin: 403722 City/District: south Goa
Mobile no: 7262074172 Telephone No. with STD code:
Aadhar Card No:269860766053 E-mail: rohansvaz14@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Baylon Oswald Sequeira Vaz Relationship with candidate: Father
Parents Date of Birth: 02 Mar 1971 Parent's/Guardian's Occupation/Designation: Safety Consultant
   
Office Address:
   
Address: Plot No. S-5, Phase I OPP. BSNL Exchange Verna Industrial Estate ,GOA
Country: India State: Goa
City/District: Verna Pin: 403722
Tel: Mobile no.: 9326127199
Fax: Email: baylonsvaz@yahoo.com
 

Education and Academic Record :


Class X: - Diploma: - 4 years Diploma in Shipbuilding Engineering
Year of Passing: 2017 Year of Joining: 2017
Board: NIOS Year of Passing: 2021
School Name: Pope John XXIII High School Board: Goa
City: Quepem Name of College/Institution: Institute Of Shipbuilding Technology
   
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 66 First year: 69
English: 85 Second year: 70
Address of School/College: Don Bosco Ganv Premnagar Quepem Third year: 91
Pin: 403705 Aggregate Percentage:
Contact Nos: 07588885027  
Email: popejohnxxiii@gmail.com  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
07/2018 football inter class midfielder
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
06/2017 computer aided drafting 1 month
06/2021 online course on marine diesel engines 2 weeks
 
Why do you wish to join TMI?: better course content and placements. The institute provides very good facilities for learning
What are your hobbies?: cycling trips,playing football and badminton,Gardening ,fitness and excercising
What are your strengths?: i am a hardworker and eargerness to learn technical innovations
What are your weaknesses?: too fast in evaluation and deciding ,and impatient
How do you intend to meet the expenses of this program?: Own Resources
 
Declaration

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

Signature of Candidate

 

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Date ________________

 
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