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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)
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| Application Summary: Diploma in Nautical Science |
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| Dossier ID: DNS2049791 |
Name: ATHARVA KAMLESH KULKARNI |
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Address: H.NO - 4047 Jain Lane Opp.Mahajan Lane,Near Laxmibai Karanja |
| Telephone No.: 9673518843 |
Mobile no: 9028224996 |
| E-mail: atharvakulkarni236@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 304426729 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049791 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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| Date ________________ |
Date ________________ |
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| 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. |
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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
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| Applicant's Personal Information: |
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| Full Name as on Class XII Marksheet/Pass Certificate: ATHARVA KAMLESH KULKARNI |
| Mother's Name: VARADA |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 18 Aug 2001 |
Nationality: INDIAN |
| Place of Birth: AHMEDNAGAR |
Personal Identification Mark: MOLE BELOW LIPS |
| Blood Group: O + |
Address for Communication: H.NO - 4047 Jain Lane Opp.Mahajan Lane,Near Laxmibai Karanja |
| State: Maharashtra |
Country: India |
| Pin: 414001 |
City/District: AHMEDNAGAR |
| Mobile no: 9028224996 |
Telephone No. with STD code: 9673518843 |
| Aadhar Card No:650178149433 |
E-mail: atharvakulkarni236@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: KAMLESH KULKARNI |
Relationship with candidate: FATHER |
| Parents Date of Birth: 03 Sep 1972 |
Parent's/Guardian's Occupation/Designation: SERVICE |
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| Office Address: |
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| Address: D5,MIDC Nagapur,Ahmednagar |
| Country: India |
State: Maharashtra |
| City/District: AHMEDNAGAR |
Pin: 414111 |
| Tel: |
Mobile no.: 9673518843 |
| Fax: |
Email: kamleshkulkarni50@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2018 |
Year of Passing: 2020 |
| Board: Maharashtra |
Board: Maharashtra |
| School: Sacred Heart Convent High School |
School: Sant Bhagwan Baba Junior Collage |
| City: AHMEDNAGAR |
City: AHMEDNAGAR |
| English %: 73 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 71 |
School/College Code: |
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Centre code: |
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Address of School/College: SANT BHAGWANBABA CHOWK,KHARWANDI |
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Pin: 414113 |
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Contact Nos: |
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Email: sbjr2000@gmail.com |
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Aggregate Percentage: |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
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| Chemistry |
100 |
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| Mathematics |
100 |
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| Physics, Chemistry & Mathematics combined Percentage: |
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| English |
100 |
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| IMU CET Application Number: |
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| Vocational and Training Courses undertaken: |
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| MONTH / YEAR (MM/YYYY) |
COURSE |
COURSE DURATION |
| 06/2018 |
CCC |
6 MONTHS |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: I will spend my time in entrance exam such as NDA And IMUCET |
| Why do you wish to join TMI?: As tmi is one of the best institute in india or even in asia so i will surely get a better knowledge And a bright future. even as i have adopted the habit of staying alone without family from last 2 years i think it we be preferable for me |
| What are your hobbies?: Swimming, Travelling |
| What are your strengths?: Hardworking |
| What are your weaknesses?: Short Tempered |
| How do you intend to meet the expenses of this program?: Bank Loan |
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| Review you documents: |
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Birth certificate
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DGS Approved Medical Fitness Certificate not uploaded
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Class X marksheet
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School leaving certificate not uploaded
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Class XII admit card not uploaded
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Class XII marksheet not uploaded
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| 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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