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.Tech. Marine Engineering
Dossier ID: DEG2175105 Name: MD MASROOF KHAN
  Address: NEW KARIMGANJ PO CHANDAUTI GAYA
Telephone No.: Mobile no: 6205147480
E-mail: mdmasroofkhan20@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: 426400307
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2175105 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.Tech. Marine Engineering
Dossier ID: DEG2175105
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: MD MASROOF KHAN
Mother's Name: ROUSHAN KHATOON
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Jul 2003 Nationality: INDIAN
Place of Birth: GAYA Personal Identification Mark: HEAD FOR RIGHT SIDE CUT
Blood Group: A +  
 
Date of Birth (DD/MM/YY): 10 Jul 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: NEW KARIMGANJ PO CHANDAUTI GAYA
State: Bihar Country: India
Pin: 823001 City/District: GAYA
Mobile no: 6205147480 Telephone No. with STD code:
Aadhar Card No:301252840470 E-mail: mdmasroofkhan20@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: MD MANSOOR KHAN Relationship with candidate: SON
Parents Date of Birth: 21 Jan 1972 Parent's/Guardian's Occupation/Designation: BUSINESS
   
Office Address:
   
Address: mirja galib gaya gaya bihar
Country: India State: Bihar
City/District: GAYA Pin: 823001
Tel: Mobile no.: 9931143658
Fax: Email: mdsaddam01786@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Bihar
School: SHATABADI PUBLIC SCHOOL GAYA School: MIRZA GHALIB COLLEGE GAYA
City: GAYA City: GAYA
English %: 89 Board Roll No./Seat No.: 21010609
Aggregate Percentage: 82 School/College Code: 110
  Address of School/College: WHITE HOUSE COMPOUND JUDGES COLONY GAYA
  Centre code: 220
  Pin: 823001
  Contact Nos:
  Email: mirzagalibgaya@gmail.com
  Aggregate Percentage: 70
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 71 71
Chemistry 100 67 67
Mathematics 100 77 77
Physics, Chemistry & Mathematics combined Percentage: 71.67
English 100 63 63
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: yes
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: marine engeneering
Why do you wish to join TMI?: yes
What are your hobbies?: reding
What are your strengths?: family
What are your weaknesses?: money
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 Class XII marksheet
 
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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