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: DNS2049803 Name: Shahnawaz
  Address: Ward No. 7 Behind Tahsil Salempur Deoria Uttar Pradesh
Telephone No.: Mobile no: 7084655580
E-mail: shahnwaja037@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 304601396
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049803 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: DNS2049803
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Shahnawaz
Mother's Name: Amtun Nisha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Jan 2002 Nationality: Indian
Place of Birth: Salempur Personal Identification Mark: Mark on chin
Blood Group: A + Address for Communication: Ward No. 7 Behind Tahsil Salempur Deoria Uttar Pradesh
State: Uttar Pradesh Country: India
Pin: 274509 City/District: Deoria
Mobile no: 7084655580 Telephone No. with STD code:
Aadhar Card No:724127868304 E-mail: shahnwaja037@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Dilzan Ansari Relationship with candidate: Father
Parents Date of Birth: 01 Aug 1968 Parent's/Guardian's Occupation/Designation: Farmer
   
Office Address:
   
Address: Ward No. 7 Behind Tahsil Salempur Deoria Uttar Pradesh
Country: India State: Uttar Pradesh
City/District: Deoria Pin: 274509
Tel: Mobile no.: 7565833530
Fax: Email: shahnwajsk1@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: St Mary Inter College School: St Mary Inter College
City: Lucknow City: Lucknow
English %: 76 Board Roll No./Seat No.: 5716677
Aggregate Percentage: 76 School/College Code: 54622
  Centre code: 5262
  Address of School/College: Sector 3 Jankipuram Ext. Lucknow
  Pin: 226021
  Contact Nos:
  Email: smicedu@gmail.com
  Aggregate Percentage: 82
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 75 75
Chemistry 100 89 89
Mathematics 100 76 76
Physics, Chemistry & Mathematics combined Percentage: 80
English 100 86 86
   
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
2015 NMTSE National 26
2019 Prefect School Captain
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I play cricket daily. I go for jogging daily. I prepare for NDA and other defence exam. Sometimes I prefer cooking food by watching its recipe on Youtube.
Why do you wish to join TMI?: At present this is the best Maritime Academy in India with maximum training, knowledge and placement percentage.
What are your hobbies?: Playing cricket and listening to the music
What are your strengths?: My strength is my stability and punctuality.
What are your weaknesses?: I am talkative and straight forward.
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate Class X marksheet School leaving certificate Class XII admit card 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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