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.Tech. Marine Engineering Course Enrolled (Second Choice): B.Sc. Nautical Science
Dossier ID: DEG2172576 Name: Piyush Surajbali Chouhan
  Address: 16 DURGA NAGAR AB ROAD INDORE M.P NEAR RAJENDRA NAGAR
Telephone No.: Mobile no: 9171838742
E-mail: piyushchouhan24x7@gmail.com  
   
Application fee payment details:  
Payment Status: Offline Payment Mode: Offline
Amount: DD Number: -
Issuing Bank: - Transaction Id: -
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2172576 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.Tech. Marine Engineering Course: Second Choice B.Sc. Nautical Science
Dossier ID: DEG2172576
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Piyush Surajbali Chouhan
Mother's Name: Asha chouhan
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 16 Apr 2003 Nationality: Indian
Place of Birth: indore Personal Identification Mark: mole on head
Blood Group: B +  
 
Date of Birth (DD/MM/YY): 16 Apr 2003 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: 16 DURGA NAGAR AB ROAD INDORE M.P NEAR RAJENDRA NAGAR
State: Madhya Pradesh Country: India
Pin: 452012 City/District: Indore
Mobile no: 9171838742 Telephone No. with STD code:
Aadhar Card No:8719 7187 9600 E-mail: piyushchouhan24x7@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SURAJ BALI CHOUHAN Relationship with candidate: FATHER
Parents Date of Birth: 25 Apr 1972 Parent's/Guardian's Occupation/Designation: TRANSPORTATION
   
Office Address:
   
Address: 21 Transport nagar Bhanwar Kuwa, Indore
Country: India State: Madhya Pradesh
City/District: indore Pin: 452001
Tel: Mobile no.: 9926094842
Fax: Email: piyushchouhan24x7@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: CBSE Board: Madhya Pradesh
School: Alpine Academy School: Lord Krishna Public School
City: Indore City: Indore
English %: 50 Board Roll No./Seat No.:
Aggregate Percentage: 63 School/College Code:
  Address of School/College: Precanco Colony, Annapurna Road, Indore
  Centre code:
  Pin: 452009
  Contact Nos: 8889997722
  Email: info@anniebesant.co.in
  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:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Starting to preparation for entrance exam for decided these engineering programme.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: This residential engineering programme give me opportunity to secure job at internationally level and performance to grace in aquatic life for build up the experience at ship craft machinery.
Why do you wish to join TMI?: Whatever I can find the best placements, learning experiences and facilities to do these residential programs. All the moral structures that I am able to seeing in your institution.
What are your hobbies?: cooking and listening the lo-fi music
What are your strengths?: controlling the angerness
What are your weaknesses?: hesitating in speaking on stage
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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