Trainee Marine Engineer

*. PERSONAL DETAILS

Surname : DHAMAL First Name : PRATIK Middle Name : TANAJI

Nationality : INDIAN Date of Birth : 18/01/1992 Place of Birth : PIMPRI

Post Applied for : Trainee Marine Engineer (TME).

Permanent Address : DHAMAL PRATIK TANAJI Present Address : DHAMAL PRATIK TANAJI

NEW GHARONDA HSG. SOC,RM48/3,MIDC NEW GHARONDA HSG SOC,RM48/3,MIDC

'G'BLOCK,SAMBHAJINAGAR CHINCHWAD,PUNE. 'G'BLOCK,SAMBHAJINAGAR CHINCHWAD,PUNE.

PIN Code: 411019 Nearest Airport: MUMBAI PIN Code: 411019

Tel No / Mobile No:+918********* Tel No / Mobile No: +918*********

Email ID: *************@*****.**

2. PASSPORT DETAILS

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

Issue

K6351506 16/11/2012 PUNE 15/11/2022 YES 33

3. CONTINUOUS DISCHARGE CERTIFICATE /INDOS

Seaman's Number Date of Issue Place of Expiry Date Remark

Book (CDC) Issue

MUM 222907 16/09/2013 mumbai 15/09/2013

Indian

INDOS 10EL1438 - - - -

4. FAMILY INFORMATION

Full Name of Next of Kin : TANAJI.R DHAMAL Relationship : Father

ADDRESS NEXT TO KIN :NEW GHARONDA HSG. SOC Tel No. : 988*******

,RM48/3,MIDC 'G'BLOCK,SAMBHAJINAGAR

CHINCHWAD,PUNE.411019

Family Data Name Contact Number/e-mail ID

Father TANAJI DHAMAL 988*******

Mother SHOBHA DHAMAL 774-***-****

Elder KISHOR DHAMAL 830-***-****

Brother

5. ACADEMIC QUALIFICATION

QUALIFICATION

YEAR OF PASSING PERCENTAGE BOARD/UNIVERSITY

B.TECH MARINE 2013 64.42 Y.C.M.O.U

DIPLOMA - - -

H.S.C. 2009 75.83 Maharashtra

S.S.C. 2007 78.46 Maharashtra

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

PERCENTAGE AVERAGE

SEMESTER

SEMESTER 1 61.84

60.33

SEMESTER 2 55.50

SEMESTER 3 61.67

SEMESTER 4 56.00

SEMESTER 5 57.67

SEMESTER 6 61.17

SEMESTER 7 61.67

SEMESTER 8

67.17

7. STCW AND OTHER CERTIFICATES

Number Dt. Of Dt. Of Pl. of Issued by

Details of Courses Issue Expiry Issue

& Certificates

Basic Fire Fighting FPFF/9108/2012-13 14/07/201 - Mumbai OERC

2

Personal Survival PST/022/12-13/01 11/07/201 - Navi UNITED MARINE

Techniques 2 Mumbai ACADEMY

Elementary First EFA/022/12-13/01 07/07/201 - Navi UNITED MARINE

Aid 2 Mumbai ACADEMY

Personal Safety & PSSR/016/12-13/01 04/07/201 - Navi UNITED MARINE

Social 2 Mumbai ACADEMY

Responsibility

(PSSR)

Certificate of MANET/STSDSD/135/201 29/05/201 - PUNE MANET PUNE

proficiency 3 3

insecurity training

for seafarers with

designated security

duties

Oil Tanker 004**********-**/09/201 - NHAVA T S RAHAMAN

Familiarisation 3

course(OTFC)

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 Name

Signature

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MIT GROUP OF INSTITUTIONS PUNE

MAHARASHTRA ACADEMY OF NAVAL EDUCATION

& TRAINING [MANET]

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

Pune-412201.

Contact this candidate