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 2021)


Application Summary:
 
Course Enrolled (First Choice): B.Sc. Nautical Science Course Enrolled (Second Choice): B.Sc. Nautical Science
Dossier ID: DEG2169753 Name: Kushagra chauhan
  Address: 312/33k lajpat nagar chowk 312/33k lajpat nagar chowk 31
Telephone No.: 09651710114 Mobile no: 9651710114
E-mail: kushagrachauhan0111@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1212.73 (Includes Convenience fee of ₹ 12.73 ) DD Number: -
Issuing Bank: - Transaction Id: 417519684
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2169753 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 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

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.Sc. Nautical Science
Dossier ID: DEG2169753
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Kushagra chauhan
Mother's Name: Rajni singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Nov 2002 Nationality: India
Place of Birth: Lucknow Personal Identification Mark: Mole On chest
Blood Group: O +  
 
Date of Birth (DD/MM/YY): 01 Nov 2002 Nationality: India
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Kushagra chauhan Passport No.: V0055041
Date of Expiry: 12 Nov 2029 Place of Issue: Lucknow
(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: 312/33k lajpat nagar chowk 312/33k lajpat nagar chowk 31
State: Uttar Pradesh Country: India
Pin: 226003 City/District: Lucknow
Mobile no: 9651710114 Telephone No. with STD code: 09651710114
Aadhar Card No:455298883368 E-mail: kushagrachauhan0111@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rajni singh Relationship with candidate: Mother
Parents Date of Birth: 01 Sep 1973 Parent's/Guardian's Occupation/Designation: House wife
   
Office Address:
   
Address: 312/33k lajpat nagar chowk 3
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226003
Tel: 09415081460 Mobile no.: 9415081460
Fax: Email: singhrajni0703@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Cathedral sr. Sec. School School: Cathedral sr. Sec. School
City: Lucknow City: Lucknow
English %: 75 Board Roll No./Seat No.:
Aggregate Percentage: 68 School/College Code:
  Address of School/College: 312/33k lajpat nagar chowk
  Centre code:
  Pin: 226003
  Contact Nos: 09651710114
  Email: kushagrachauhan0111@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
10/2016 Basketball Inter school 1st
07/2017 Table tennis junior Inter school 1st
09/2019 Table tennis senior Inter school 1st
10/2019 Dance Inter city 2nd runner up
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I would like do more physical activities like improving in sports and dance. I will try to do some intense work out at home or at gym. And at last I would like to go on trips to explore more things.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Nautical science
Why do you wish to join TMI?: I am really interested in merchant Navy.
What are your hobbies?: Dancing and playing cricket and basketball
What are your strengths?: I am good in physical activities
What are your weaknesses?: Academics
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Your passport Class X marksheet Leaving / Transfer Certificate / Birth Certificate 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

 

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Date ________________

 
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