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: PRIYANSHU SRIVASTAVA
Mother's Name: JYOTSNA SRIVASTAVA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Apr 2003 Nationality: INDIAN
Place of Birth: GORAKHPUR Personal Identification Mark: MARK BESIDES RIGHT EYE
Blood Group: B +  
 
Date of Birth (DD/MM/YY): 22 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: C-501,SILVERLINE APARTMENT GANESHPUR RAHMANPUR
State: Uttar Pradesh Country: India
Pin: 226028 City/District: LUCKNOW
Mobile no: 9336891520 Telephone No. with STD code:
Aadhar Card No:707117625351 E-mail: ojaspriyansh319@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: NAVEEN SRIVASTAVA Relationship with candidate: FATHER
Parents Date of Birth: 10 Apr 1969 Parent's/Guardian's Occupation/Designation: SERVICE
   
Office Address:
   
Address: TANTIA CONSTRUCTION LTD.,DD30,SECTOR-1 SALT LAKE CITY
Country: India State: West Bengal
City/District: KOLKATA Pin: 700064
Tel: Mobile no.: 7004105225
Fax: Email: naveenjrp@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: JP EDUCATION ACADEMY School: JAGRAN PUBLIC SCHOOL
City: GORAKHPUR City: LUCKNOW
English %: 64 Board Roll No./Seat No.:
Aggregate Percentage: 75 School/College Code:
  Address of School/College: VIRAJ KHAND-2,SECTOR 6,GOMTI NAGAR
  Centre code:
  Pin: 226010
  Contact Nos:
  Email: ojaspriyansh319@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:  
 
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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