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.Sc. Nautical Science
Dossier ID: DEG2188332 Name: Suryansh Tiwari
  Address: 1611,Khushi Vihar Colony Hardoi Ring Road, Behind IRITM Kanausi, Lucknow
Telephone No.: 7338905186 Mobile no: 7338905186
E-mail: rajivtiwari211@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1282.6 (Includes Convenience fee of ₹ 82.6 ) DD Number: -
Issuing Bank: - Transaction Id: 440874780
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2188332 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.Sc. Nautical Science
Dossier ID: DEG2188332
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Suryansh Tiwari
Mother's Name: Meena Tiwari
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Dec 2003 Nationality: Indian
Place of Birth: Lucknow Personal Identification Mark: A black mole on right side of neck
Blood Group: B +  
 
Date of Birth (DD/MM/YY): 23 Dec 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: 1611,Khushi Vihar Colony Hardoi Ring Road, Behind IRITM Kanausi, Lucknow
State: Uttar Pradesh Country: India
Pin: 226011 City/District: Lucknow
Mobile no: 7338905186 Telephone No. with STD code: 7338905186
Aadhar Card No:533080838943 E-mail: rajivtiwari211@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rajiv Kumar y Relationship with candidate: Father
Parents Date of Birth: 20 Sep 1980 Parent's/Guardian's Occupation/Designation: Bank employee
   
Office Address:
   
Address: National Bank for agricultural and rural development Vipin khand, gomti nagar Lucknow
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226010
Tel: 07358594280 Mobile no.: 7338905186
Fax: Email: rajivtiwari211@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Kendriya Vidhyalaya RDSO School: Kendriya Vidhyalaya y
City: Lucknow City: Lucknow
English %: 78 Board Roll No./Seat No.:
Aggregate Percentage: 78 School/College Code:
  Address of School/College: Kendriya Vidhyalaya RDSO, MANAK NAGAR, LUCKNOW
  Centre code:
  Pin: 226011
  Contact Nos:
  Email: clusterrdso@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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
07/2014 Scout and guide Pravesh Successfully completed
04/2015 Scout and guide Pratham sopan Successfully completed
09/2016 Scout and guide Dwitiya sopan Successfully completed
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: By studying for forthcoming entrance exams
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: To make my future as marine engineer.
Why do you wish to join TMI?: It is best institute.
What are your hobbies?: Swimming, reading, outdoor games
What are your strengths?: Will power
What are your weaknesses?: Emotions
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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