Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2020)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2049700 Name: Pawan Kumar Yadav
  Address: Saraswati Nagar, Near bus stand Bara Ghazipur
Telephone No.: Mobile no: 7388232792
E-mail: kpawangzp1999@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.83 (Includes Convenience fee of ₹ 4.83 ) DD Number: -
Issuing Bank: - Transaction Id: 304263282
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049700 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
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2020

 
  Dossier ID: DNS2049700
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Pawan Kumar Yadav
Mother's Name: Seema Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Sep 1999 Nationality: Indian
Place of Birth: Bara Personal Identification Mark: Back head two cm scar
Blood Group: O + Address for Communication: Saraswati Nagar, Near bus stand Bara Ghazipur
State: Uttar Pradesh Country: India
Pin: 232325 City/District: Ghazipur
Mobile no: 7388232792 Telephone No. with STD code:
Aadhar Card No:787619477387 E-mail: kpawangzp1999@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rajesh Singh Yadav Relationship with candidate: Father
Parents Date of Birth: 12 Feb 1975 Parent's/Guardian's Occupation/Designation: Ex-servicemen
   
Office Address:
   
Address: Saraswati Nagar, Near bus stand Bara Ghazipur
Country: India State: Uttar Pradesh
City/District: Ghazipur Pin: 232325
Tel: Mobile no.: 8638042262
Fax: Email: kpawangzp1999@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2016 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Crescent Convent School School: APS RANCHI
City: Dildar Nagar Ghazipur City: RANCHI
English %: 85 Board Roll No./Seat No.:
Aggregate Percentage: 83 School/College Code:
  Centre code:
  Address of School/College: Dipatoli Cantt, Ranchi
  Pin: 834001
  Contact Nos:
  Email: asr8208@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 ?: Working on our personality
Why do you wish to join TMI?: Best maratine institute
What are your hobbies?: sport and gyming
What are your strengths?: Confidante
What are your weaknesses?: Gullible
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card 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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