MIT GROUP OF INSTITUTIONS PUNE

MAHARASHTRA ACADEMY OF NAVAL EDUCATION

& TRAINING [MANET]

Gat No.140, Loni-Kalbhor, Rajbaug, Pune-Solapur Highway, Pune-412201.

Photograph

1. PERSONAL DETAILS

Surname : PAL First Name :ATUL Middle Name :AMRIT

Nationality : INDIAN Date of Birth :02/12/1991 Place of Birth : SANT RAVIDAS

NAGAR U. P.

Post Applied for : Trainee Marine Engineer

Permanent Address : Present Address :

AMRIT LAL PAL, HNO. 202, SHUBH VIHAR, BEHIND

Hno. 263, vill. Poorebahuriya,Teh. Gyanpur, Dist. Sant

BOLLYWOOD CINEMAS, WADGAON SHERI, PUNE,

Ravidas Nagar, UP.

MAHARASHTRA.

PIN Code:221303 Nearest Airport: Varanasi PIN Code: 411014

Tel No / Mobile: 084******** Tel No / Mobile No:094********

Email ID: acfm6c@r.postjobfree.com

2. PASSPORT DETAILS

Passport No. Date of Place of Issue Date of Exp. ECNR Blank Pages

Issue

K9905336 LUCKNOW 13.03.2023

14.03.2013

3. CONTINUOUS DISCHARGE CERTIFICATE /INDOS

Seaman’s

Number Date of Issue Place of Issue Expiry Date Remark

Book (CDC)

Indian

INDOS

4. FAMILY INFORMATION

Relationship : Father

Full Name of Next of Kin : AMRIT LAL PAL

Address: AMRIT LAL PAL, HNO. 202, SHUBH VIHAR, BEHIND BOLLYWOOD CINEMAS, WADGAON SHERI,

PUNE, MAHARASHTRA.

Tel No. : 919*********

Family Data Name Contact Number/e-mail ID

AMRIT LAL PAL

Father 094********, acfm6c@r.postjobfree.com

GEETA PAL

Mother 762*******

Brother

PRATIBHA PAL

Sister 989*******, acfm6c@r.postjobfree.com

5. ACADEMIC QUALIFICATION

QUALIFICATION YEAR OF PASSING PERCENTAGE BOARD/UNIVERSITY

2014 69.8 %

B.TECH MARINE Y.C.M.O.U

2010 81.8% CBSE

H.S.C.

2008 83.8% CBSE

S.S.C.

6. DETAILS OF B.TECH (MARINE) COURSE:

SEMESTER PERCENTAGE AVERAGE

SEMESTER 1 75.00%

SEMESTER 2 74.17%

SEMESTER 3 69.33%

SEMESTER 4 64.17%

69.93%

SEMESTER 5 68.50%

SEMESTER 6 67.00%

SEMESTER 7 71.33%

SEMESTER 8 69.8 %

7. STCW AND OTHER CERTIFICATES

Details of Courses & Dt. Of Dt. Of Pl. of

Number Issued by

Certificates Issue Expiry Issue

Basic Fire Prevention and 13.07.2018

FPFF/0474/047/13 13/07/2013 Mumbai NAMAC

fire Fighting

10.07.2018

Personal Survival Technique PST/0441/041/13 10/07/2013 Mumbai NAMAC

unlimited

Elementary First Aid EFA/0346/026/13 06/07/2013 Mumbai NAMAC

Personal Safety & Social PSSR/0568/044/13 unlimited

03/07/2013 Mumbai NAMAC

Responsibility (PSSR)

8. Dangerous Cargo Endorsements

Dangerous Cargo Grade / Level Date of Place of Date Of

Number

Endorsements I / II Issue Issue Expiry

9. DECLARATION

I hereby affirm that all the information provided by me in this application is true and correct to the best of my

knowledge and belief; further, that no Certificate issued to me has ever been Revoked or Suspended.

Date – 29.06.2014 Name: ATUL A. PAL Signature

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