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: DEG2181887 Name: PRATYUSH PRIYADARSHI
  Address: 190/1907 ,RAGHUNATH NAGAR SISUPALGARH BHUBANESWAR
Telephone No.: 09437516016 Mobile no: 9437516016
E-mail: pritipiyushadas@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1282.6 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 437337390
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2181887 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: DEG2181887
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PRATYUSH PRIYADARSHI
Mother's Name: PRITI PIYUSHA DAS
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 08 Aug 2003 Nationality: INDIAN
Place of Birth: BHUBANESWAR Personal Identification Mark: BLACK SPOT BELOW RIGHT EYE
Blood Group: O +  
 
Date of Birth (DD/MM/YY): 08 Aug 2003 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : NA Passport No.: NA
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: 190/1907 ,RAGHUNATH NAGAR SISUPALGARH BHUBANESWAR
State: Orissa Country: India
Pin: 751002 City/District: KHORDHA
Mobile no: 9437516016 Telephone No. with STD code: 09437516016
Aadhar Card No:737816961833 E-mail: pritipiyushadas@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: PRAMOD KUMAR MALLIK Relationship with candidate: FATHER
Parents Date of Birth: 10 Feb 1971 Parent's/Guardian's Occupation/Designation: Deputy Superintendent of Police
   
Office Address:
   
Address: SP OFFICE PANIKOILI JAJPUR
Country: India State: Orissa
City/District: JAJPUR Pin: 755043
Tel: 09437516016 Mobile no.: 9437203480
Fax: Email: pritipiyushadas@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: ST. XAVIER HIGH SCHOOL School: GOURI SHANKAR ENGLISH MEDIUM SCHOOL
City: BHUBANESWAR City: BHUBANESWAR
English %: 95 Board Roll No./Seat No.:
Aggregate Percentage: 68 School/College Code:
  Address of School/College: sisupalgarh
  Centre code:
  Pin: 751002
  Contact Nos: 9437178262
  Email: gsrem@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 ?: I intend to play football with our inter school groups and to do swimming in my village river .
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I am always adventurous and like to visit the new places . And blue water always passionate me .
Why do you wish to join TMI?: This is a big and reputed Institute in the field of marine engineering , providing a bright and adventurous life to those who aspire it .
What are your hobbies?: Playing football , swimming and exercising.
What are your strengths?: I am flexible , energetic and always eager to do new things .
What are your weaknesses?: I always find myself insufficient for project and critic of myself.
How do you intend to meet the expenses of this program?: Own Resources
 
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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