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: DEG2186059 Name: SHIVANSH SHUBHAM
  Address: B-5/1, UMESH ENCLAVE, SHER-E-PUNJAB CHOWK, BESIDE RADIO STATION, ADITYAPUR, JAMSHEDPUR, JHARKHAND
Telephone No.: Mobile no: 9204058603
E-mail: sdsharma@mithilamotors.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 438068569
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2186059 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: DEG2186059
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: SHIVANSH SHUBHAM
Mother's Name: ARCHANA KUMARI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Nov 2000 Nationality: INDIAN
Place of Birth: JAMSHEDPUR Personal Identification Mark: CUT MARK ON LEFT HAND
Blood Group: A +  
 
Date of Birth (DD/MM/YY): 17 Nov 2000 Nationality: INDIAN
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : SHIVANSH SHUBHAM Passport No.: S9356298
Date of Expiry: 27 Dec 2028 Place of Issue: RANCHI
(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: B-5/1, UMESH ENCLAVE, SHER-E-PUNJAB CHOWK, BESIDE RADIO STATION, ADITYAPUR, JAMSHEDPUR, JHARKHAND
State: Jharkhand Country: India
Pin: 831013 City/District: JAMSHEDPUR
Mobile no: 9204058603 Telephone No. with STD code:
Aadhar Card No:769912538628 E-mail: sdsharma@mithilamotors.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SHIVDUTTA SHARMA Relationship with candidate: FATHER
Parents Date of Birth: 01 Jan 1971 Parent's/Guardian's Occupation/Designation: SERVICE/ FINANCE HEAD
   
Office Address:
   
Address: MITHILA MOTORS PVT. LTD. ADITYAPUR INDUSTRIAL AREA, JAMSHEDPUR, JHARKHAND
Country: India State: Jharkhand
City/District: JAMSHEDPUR Pin: 831013
Tel: Mobile no.: 9204058603
Fax: Email: sdsharma@mithilamotors.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2021
Board: CBSE Board: NIOS
School: The Scindia School School: BBOSE
City: Gwalior City: PATNA
English %: 80 Board Roll No./Seat No.:
Aggregate Percentage: 70 School/College Code:
  Address of School/College: Chanakya National Law University Campus, Nyay Nagar, Mithapur, Patna-800001
  Centre code:
  Pin: 800001
  Contact Nos:
  Email: info@bbose.org
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
06/2016 kennedy Space center visitor participation
08/2016 All india IPSC Basketball National participation
05/2017 Mount Everest Base Camp Everest Base Camp participation
10/2015 HOB Explorer Programme National participation
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
03/2015 Entry level Certificate in ESOL international February 2015
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparation for different entrance level exam.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I have been a member of my school swimming team in SCINDIA and i have interest in travelling to different places along with learning new skills. Which I think Marine engineering provides the platform. Also, I have a love towards sea which is why i involve myself in activities such as river rafting, mountain trekking and other related activities.
Why do you wish to join TMI?: it is one of the best institute for marine engineering which is also providing good placement.
What are your hobbies?: Swimming, mountain trekking, river rafting
What are your strengths?: swimming, good presence of mind
What are your weaknesses?: impatient
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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