Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Marine Engineering / Nautical Science Degree Programmes
(New Admission B.Tech. Marine Engineering / B.Sc. Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
Course: First Choice B.Sc. Nautical Science Course: Second Choice B.Tech. Marine Engineering
Dossier ID:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Dindayal Chaurasia
Mother's Name: Urmila devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Feb 2002 Nationality: Indian
Place of Birth: BALLIA Personal Identification Mark: Birthmark on left ear
Blood Group: A +  
 
Date of Birth (DD/MM/YY): 12 Feb 2002 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Passport No.:
Date of Expiry: Place of Issue:
(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.)
 
Address for Communication: 387,New Basti Chandpur Singhi,bisouli Sahatwar,Ballia
State: Uttar Pradesh Country: India
Pin: 277211 City/District: BALLIA
Mobile no: 8527001206 Telephone No. with STD code: 08527001206
Aadhar Card No:365615519302 E-mail: arjunreddy935som@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Dindayal Chaurasia Relationship with candidate: Father
Parents Date of Birth: 01 Oct 1976 Parent's/Guardian's Occupation/Designation: Private job
   
Office Address:
   
Address: 387,New Basti Chandpur Singhi,bisouli
Country: India State: Uttar Pradesh
City/District: BALLIA Pin: 277211
Tel: 9198065905 Mobile no.: 9198065905
Fax: Email: arjunreddy935som@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: Year of Passing:
Board: Board:
School: School:
City: City:
English %: Board Roll No./Seat No.:
Aggregate Percentage: School/College Code:
  Address of School/College:
  Centre code:
  Pin:
  Contact Nos:
  Email:
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
Physics, Chemistry & Mathematics combined Percentage:
English
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
 
Review you documents:
Your passport not uploaded Class X marksheet not uploaded Leaving / Transfer Certificate / Birth Certificate not uploaded Class XII admit card not uploaded Class XII marksheet not uploaded
 
Declaration

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

Signature of Candidate

 

___________________

Date ________________

 
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