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.Tech. Marine Engineering
Dossier ID: DEG2185091 Name: PANCHURIKA GOGOI
  Address: RAJGARH DIBRUGARH ASSAM
Telephone No.: Mobile no: 9401746004
E-mail: gogoiiika101@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 436515370
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2185091 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.Tech. Marine Engineering
Dossier ID: DEG2185091
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PANCHURIKA GOGOI
Mother's Name: SEEMA GOGOI
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Mar 2003 Nationality: INDIAN
Place of Birth: RAJGARH Personal Identification Mark: BLACK MOLE NEAR RIGHT EYE
Blood Group: B +  
 
Date of Birth (DD/MM/YY): 01 Mar 2003 Nationality: INDIAN
Gender (M/F): Female 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: RAJGARH DIBRUGARH ASSAM
State: Assam Country: India
Pin: 786611 City/District: DIBRUGARH
Mobile no: 9401746004 Telephone No. with STD code:
Aadhar Card No:229423823032 E-mail: gogoiiika101@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SEEMA GOGOI Relationship with candidate: MOTHER
Parents Date of Birth: 01 Mar 1977 Parent's/Guardian's Occupation/Designation: HOUSEWIFE
   
Office Address:
   
Address: RAJGARH DIBRUGARH DIBRUGARH
Country: India State: Assam
City/District: DIBRUGARH Pin: 786611
Tel: Mobile no.: 9435092191
Fax: Email: gogoiiika101@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Assam Board: Assam
School: THE NEW STAR SCHOOL School: SALT BROOK ACADEMY
City: DIBRUGARH City: DIBRUGARH
English %: 88 Board Roll No./Seat No.:
Aggregate Percentage: 92 School/College Code:
  Address of School/College: DIBRUGARH, ASSAM
  Centre code:
  Pin: 786003
  Contact Nos:
  Email: gogoiiika101@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 ?: PREPEARING FOR B.SC. NAUTICAL SCIENCE
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I LIKE SHIPS AND SAILING
Why do you wish to join TMI?: BECAUSE,IT IS ONE OF THE BEST MARITUM INSTITUTE AS PER MY KNOWLEDGE
What are your hobbies?: DANCING, PLAYING
What are your strengths?: I AM HEALTHY AND HARD WORKING
What are your weaknesses?: LOW CONFIDENCE
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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