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: DEG2171358 Name: SHUBHAM SURESH PATYEKAR
  Address: Patye Punarvas,near the marathi school Patye Punarvas, near the temple Patye Punarvas, Dodamarg
Telephone No.: 9404169606 Mobile no: 8381032370
E-mail: shubhampatyekar7@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425333778
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2171358 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: DEG2171358
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: SHUBHAM SURESH PATYEKAR
Mother's Name: Shubhangi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Dec 2002 Nationality: INDIAN
Place of Birth: Sawantwadi Personal Identification Mark: Black spot in left shoulder
Blood Group: AB +  
 
Date of Birth (DD/MM/YY): 09 Dec 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: Patye Punarvas,near the marathi school Patye Punarvas, near the temple Patye Punarvas, Dodamarg
State: Maharashtra Country: India
Pin: 416512 City/District: Sindhudurg
Mobile no: 8381032370 Telephone No. with STD code: 9404169606
Aadhar Card No:540141407054 E-mail: shubhampatyekar7@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Suresh Relationship with candidate: Son
Parents Date of Birth: 04 Apr 1968 Parent's/Guardian's Occupation/Designation: Peun in Government school
   
Office Address:
   
Address: M.R.Naik.Mahavadalay marathi school, Konalkatta, Tilari Colni, M.R.Naik.Mahavadalay. Near Tilari colni
Country: India State: Maharashtra
City/District: Sindhudurg Pin: 416549
Tel: 9420247155 Mobile no.: 9420247155
Fax: Email: shubhampatyekar7@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: Maharashtra Board: Maharashtra
School: KARUNA.SADAN.SCHOOL School: Rajmata Satvashiladevi Bhonsle Junior College.
City: Sawantwadi City: Sawantwadi
English %: 52 Board Roll No./Seat No.:
Aggregate Percentage: 64 School/College Code:
  Address of School/College: Sawantwadi, near moti talav.
  Centre code:
  Pin: 416510
  Contact Nos: 02363272017
  Email: spkcollege@yahoo.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
12/2018 ELEMENTARY EXAM STATE LEVEL C
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I WILL SEARCH FOR THE BEST CAREER OPRION FOR MYSELF THROUGH NET AND PERSONAL VISITING TO THE INSTITUTES.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: BEING ONE OF THE BEST CAREER OPTION AND MY DREAM TO TRAVEL THE WORLD AND THE WORK THAT I COULD LOVE MAKES ME PASSIONATE ABOUT NAUTICAL SCIENCE.
Why do you wish to join TMI?: PREMIER IN THE FIELD AND BEST UPTO MY KNOWLEDGE.
What are your hobbies?: TRAVELLING AND EXPECITION MY HOBBIES
What are your strengths?: PASSION, DEDICATION, QUICK LEARNER
What are your weaknesses?: FOREIGN LANGUAGES, TAKING TOO MUCCH RISKS
How do you intend to meet the expenses of this program?: Bank Loan
 
Review you documents:
Your passport not uploaded 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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