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: DNS2049811 Name: Na
  Address: Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh
Telephone No.: Mobile no: 7376390446
E-mail: premyadav36940@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 304531893
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049811 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: DNS2049811
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Na
Mother's Name: Ramkali Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 19 Sep 2001 Nationality: Indian
Place of Birth: Uttar Prade Personal Identification Mark: There is a mole on the right side of the lips
Blood Group: O + Address for Communication: Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh
State: Uttar Pradesh Country: India
Pin: 233311 City/District: Ghazipur
Mobile no: 7376390446 Telephone No. with STD code:
Aadhar Card No:980504390177 E-mail: premyadav36940@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rambhavan Singh Yadav Relationship with candidate: Father
Parents Date of Birth: 08 Jun 1976 Parent's/Guardian's Occupation/Designation: Defence service
   
Office Address:
   
Address: Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh Village - kukudha, Post- sujanipur ,Dis. -Ghazipur ,Uttar Pradesh
Country: India State: Uttar Pradesh
City/District: Ghazipur Pin: 233311
Tel: Mobile no.: 9149770440
Fax: Email: cutypie1891981@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: Rajasthan
School: Navneeta Kunwar Public School School: R. N. Tagore public sr. Se. School
City: Varanasi City: Jhunjhunu
English %: 70 Board Roll No./Seat No.:
Aggregate Percentage: 62 School/College Code:
  Centre code:
  Address of School/College: Mandawa road, Sitsar, Jhunjhunu, Sitsar, Rajasthan State Highway 41, Jhunjhunu,
  Pin: 333001
  Contact Nos:
  Email: tts5234155@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 ?: I want to visit to historical places
Why do you wish to join TMI?: many people told me that you join Tolani Institute and they are also said that the faculty ,facility etc. there is very good and it deserves trust.
What are your hobbies?: Playing cricket and volleyball
What are your strengths?: Whatever I do, I do it carefully
What are your weaknesses?: There is a little hesitation when I go to do something for the first time
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded 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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