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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: DNS2049949 |
Name: lakshdeep |
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Address: h.no.1334/st.no.13,gurbax colony, patiala Gurbax colony |
| Telephone No.: |
Mobile no: 9509805200 |
| E-mail: lakshsharma566@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: 304836338 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049949 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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___________________ |
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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: lakshdeep |
| Mother's Name: paramjeet |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 04 May 2000 |
Nationality: Indian |
| Place of Birth: patiala |
Personal Identification Mark: scar near right elbow |
| Blood Group: O + |
Address for Communication: h.no.1334/st.no.13,gurbax colony, patiala Gurbax colony |
| State: Punjab |
Country: India |
| Pin: 147001 |
City/District: patiala |
| Mobile no: 9509805200 |
Telephone No. with STD code: |
| Aadhar Card No:478906579691 |
E-mail: lakshsharma566@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Balwinder sharma |
Relationship with candidate: father |
| Parents Date of Birth: 18 Oct 1966 |
Parent's/Guardian's Occupation/Designation: civil engineer |
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| Office Address: |
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| Address: h.no.1334/st.no.13,gurbax colony, patiala Gurbax colony |
| Country: India |
State: Punjab |
| City/District: patiala |
Pin: 147001 |
| Tel: |
Mobile no.: 9815003620 |
| Fax: |
Email: balvindersharma686@yahoo.in |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2016 |
Year of Passing: 2018 |
| Board: Punjab |
Board: Punjab |
| School: play ways senior secondary school |
School: play ways senior secondary school |
| City: Patiala |
City: Patiala |
| English %: 95 |
Board Roll No./Seat No.: 2018100876 |
| Aggregate Percentage: 91 |
School/College Code: 0081065 |
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Centre code: 63040 |
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Address of School/College: Soda water street, Lahori gate, Patiala |
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Pin: 147001 |
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Contact Nos: |
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Email: rajdeep_pwhs@yahoo.co.in |
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Aggregate Percentage: 79 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
70 |
70 |
| Chemistry |
100 |
84 |
84 |
| Mathematics |
100 |
79 |
79 |
| Physics, Chemistry & Mathematics combined Percentage: |
77.67 |
| English |
75 |
70 |
93.33 |
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| IMU CET Application Number: |
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| Sports & Extra Curricular Activities: |
| Achievements in Sports and Extra Curricular Activities |
| MONTH / YEAR (MM/YYYY) |
SPORT/ACTIVITY |
LEVEL OF PARTICIPATION |
POSITION |
| 06/2015 |
NCC |
state |
cadet |
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| Vocational and Training Courses undertaken: |
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| MONTH / YEAR (MM/YYYY) |
COURSE |
COURSE DURATION |
| 09/2018 |
STCW |
13 days |
| 09/2018 |
STSDSD |
2 days |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: I worked on fuel barge Pushpa as an ordinary seaman for 9 months. |
| Why do you wish to join TMI?: I want to join TMI as this is the best institute in India. TMI has the best faculty and with the help of them, I will be able to achieve my goals in the best way. |
| What are your hobbies?: swimming and cooking |
| What are your strengths?: punctual, hard working, work better under pressure |
| What are your weaknesses?: take shortcuts |
| How do you intend to meet the expenses of this program?: Other - salary from job |
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| Review you documents: |
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Birth certificate
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DGS Approved Medical Fitness Certificate
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Class X marksheet
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School leaving certificate
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Class XII admit card
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Class XII marksheet
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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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