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: DNS2049728 Name: Chirag B Poojary
  Address: Samruddhi sasithota kuthpady,udupi,Karnataka Janaki nivas sasithota kuthpady,udupi,Karnataka
Telephone No.: Mobile no: 9880909004
E-mail: chiragb305@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 304313474
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049728 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: DNS2049728
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Chirag B Poojary
Mother's Name: Jyothi B
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Aug 2002 Nationality: Indian
Place of Birth: Kuthpady Personal Identification Mark: Mole on forehead
Blood Group: O + Address for Communication: Samruddhi sasithota kuthpady,udupi,Karnataka Janaki nivas sasithota kuthpady,udupi,Karnataka
State: Karnataka Country: India
Pin: 574118 City/District: Udupi
Mobile no: 9880909004 Telephone No. with STD code:
Aadhar Card No:663432709560 E-mail: chiragb305@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SP Balakrishna Relationship with candidate: Father
Parents Date of Birth: 01 Sep 1972 Parent's/Guardian's Occupation/Designation: Driver
   
Office Address:
   
Address: Bsnl telephone exchange udupi Bsnl telephone exchange udupi
Country: India State: Karnataka
City/District: Udupi Pin: 574118
Tel: Mobile no.: 9449715381
Fax: Email: bk590231@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Karnataka Board: Karnataka
School: St.Francis xavier english medium school School: Shyamili indp pu college
City: Udupi City: Udupi
English %: 77 Board Roll No./Seat No.:
Aggregate Percentage: 84 School/College Code:
  Centre code:
  Address of School/College: Shyamili indnp pu college Kidiyur Udupi 576103
  Pin: 576103
  Contact Nos:
  Email: bk590231@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
Physics, Chemistry & Mathematics combined Percentage:
English
   
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
12/2016 Karate Open National level Second
07/2017 Karate Taluk school level First
08/2017 Karate District level Second
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will utilise my time for the preparation of sponsorship test and for imu cet
Why do you wish to join TMI?: Many itf company are tie up with tmi and the infrastructure is also good when compared to other college and my friend told me that they will teach discipline and the education is also good.
What are your hobbies?: My hobby is swimming
What are your strengths?: Self confident
What are your weaknesses?: Straight forward
How do you intend to meet the expenses of this program?: 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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