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: DEG2192096 Name: Shivam Pachauri
  Address: SMQ 49/9 , New Pinto Park Air Force Station Palam
Telephone No.: 0992 849 7840 Mobile no: 9928497840
E-mail: shivampachauriking99@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200.00 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 13692084409
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2192096 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: DEG2192096
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Shivam Pachauri
Mother's Name: Rama Pachauri
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 16 Mar 2003 Nationality: Indian
Place of Birth: Palam Personal Identification Mark: Mole on Left Hand Wrist
Blood Group: O +  
 
Date of Birth (DD/MM/YY): 16 Mar 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: SMQ 49/9 , New Pinto Park Air Force Station Palam
State: Delhi Country: India
Pin: 110010 City/District: South West Delhi
Mobile no: 9928497840 Telephone No. with STD code: 0992 849 7840
Aadhar Card No:310161878960 E-mail: shivampachauriking99@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sushil Kumar Pachauri Relationship with candidate: Father
Parents Date of Birth: 25 Sep 1968 Parent's/Guardian's Occupation/Designation: Defence Services
   
Office Address:
   
Address: SMQ 49/9 , New Pinto Park Air Force Station Palam
Country: India State: Delhi
City/District: South West Delhi Pin: 110010
Tel: 09928497840 Mobile no.: 7597368612
Fax: Email: shivampachauriking99@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: CBSE Board: Uttar Pradesh
School: Kendriya Vidyalaya No.2 School: Habib Khan Inter College
City: Jodhpur City: Aligarh
English %: 66 Board Roll No./Seat No.: 215233614
Aggregate Percentage: 70 School/College Code: 1602
  Address of School/College: Jirauli Hirasingh Road , Akrabad , Aligarh
  Centre code: 00
  Pin: 202121
  Contact Nos: 7947135399
  Email: shivampachauriking99@gmail.com
  Aggregate Percentage: 65
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 70 70
Chemistry 100 72 72
Mathematics 100 55 55
Physics, Chemistry & Mathematics combined Percentage: 65.67
English 100 65 65
   
IMU CET Application Number: CET21U1005932  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
11/2015 Volleyball School Level First
11/2015 Basketball School Level First
05/2018 Football Regional Level NIL
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
11/2017 National Cadet Corps Two Years
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparation of NDA/NA Exam.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Marine Engeneering/Nautical Science is always good option for me because I want to saw the shipping industry and sail the world at large.
Why do you wish to join TMI?: I have so many options but right now I choose this one because it gives me feel like Armed Forces which is most satisfactory thing for me.
What are your hobbies?: Playing Football and Study
What are your strengths?: Leadership Quality
What are your weaknesses?: Being too Sensitive
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
 
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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