*

MIT GROUP OF INSTITUTIONS PUNE

MAHARASHTRA ACADEMY OF NAVAL EDUCATION

& TRAINING [MANET]

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

1. PERSONAL DETAILS

Surname : Patidar First Name : Praveen Middle Name : Nationality : Indian Date of Birth : 18

th, Jan 1994 Place of Birth : Chakrod, M.P.

Weight (kg) : 64 Height (cm) : 184 BMI : 18.90

Post Applied for : Trainee Marine Engineer

Permanent Address : Ward 10, HN 211, G.P. Chakrod, Present Address : Ward 10, HN 211, G.P. Chakrod, Dist- Shajapur, Dist- Shajapur,

Madhya Pradesh. Madhya Pradesh.

PIN Code: 465335

Nearest Airport: Indore, Madhya

PIN Code: 465335

Pradesh

Mobile No: 916-***-****, 787-***-**** Mobile No: 947-***-****, 992-***-**** Email ID: ac9n56@r.postjobfree.com

2. PASSPORT DETAILS

Passport No. Date of Issue Place of Issue Date of Exp. ECNR Blank Pages P2222279 07/11/2016 Bhopal 06/11/2026 - 36

3. CONTINUOUS DISCHARGE CERTIFICATE / INDOS

Seaman’s Book

Number Date of Issue Place of Issue Expiry Date Remark

(CDC)

INDIAN MUM 303402 07/04/2018 Mumbai 06/04/2028 -

INDOS 17EL1729 19/09/2014

Mumbai - -

4. FAMILY INFORMATION

Full Name of Next of Kin : Jagdish Patidar Relationship : Father Address of Next of Kin: WN 10 HN 211 GP Chakrod,

Tel No. : 992-***-****

Dist- Shajapur, Madhya Pradesh, Pin- 465335

Family

Name

Occupation

Contact Number/e-mail ID

Data

Father Jagdish Patidar Farmer 947-***-****

Mother Kiran Patidar Home maker 940-***-****

Brother Bhupendra Patidar Civil Engineer 787-***-**** 5. ACADEMIC QUALIFICATION

QUALIFICATION

YEAR OF

PASSING

PERCENTAGE

PCM

PERCENTAGE

BOARD/UNIVERSITY

B.Tech Marine

Engineering

2018 71.28%

IMU

12th 2014 91.40% 93.66% STATE BOARD

10th 2012 73.28% I.C.S.E. BOARD

6. DETAILS OF B.TECH MARINE ENGINEERING COURSE:

SEMESTER PERCENTAGE AVERAGE %

SEMESTER 1 70.86%

SEMESTER 2 71.57%

SEMESTER 3 71.45%

71.28%

SEMESTER 4 71.63%

SEMESTER 5 69.81 %

SEMESTER 6 70.45%

SEMESTER 7 72.50%

SEMESTER 8 72.00%

7. STCW AND OTHER COURSES

Details of Courses &

Number

Dt. Of

Pl. of Issue Issued by

Certificates Issue

ELEMENTARY FIRST AID AIIMT / EFA/GN/B295/7104 18/07/2017 Varanasi Asha International Institute

of Marine Technology

PERSONAL SAFETY AND

SOCIAL RESPONSIBILITY

AIIMT/PSSR/GN/B274/6589 28/07/2017 Varanasi

Asha International Institute

of Marine Technology

FIRE PREVENTION AND FIRE

FIGHTING

6D4A59E9E814262E 06/07/2017 Mumbai Naval Maritime Academy PERSONA SURVIVAL

TECHNIQUES

AIIMT/PST/GN/B212/5054 15/07/2017 Varanasi

Asha International Institute

of Marine Technology

SECURITY TRAINING FOR

SEA FARERS WITH

AIIMT/DSD/GN/B135/GN 21/07/2017 Varanasi

Asha International Institute

DESIGNATED SECURITY of Marine Technology

8.HOBBIES AND INTEREST

Photography, Cinematography, Cricket, Volleyball.

9. OTHER CERTIFICATES

Sr.No.

Details of the Certificates

1. Certificate Of Securing Runner Up Position in State Level Cricket Tournament In Inter- Collegiate Vishwanath Sports Meet

2. Certificate Of Participation in 23

rd

Senior National Sepaktakraw Championship 2012

3. Certificate Of Securing Runner Up Position in Inter-Campus Cricket Tournament 4. Certificate Of winning in Block Level Volley Ball Tournament 5. Certificate of Participation in Inter-Maritime fest Naughtica 2017 10. 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: 04/06/2018 Name: Praveen Patidar Signature :

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