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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: DNS2049971 |
Name: Shetty Sainath Bhaskar |
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Address: 3-135 kunjadi house, balakatta garadi , hirebettu udupi karnataka. 3-135 kunjadi house ,balakatta garadi, hirebettu,udupi,karnataka |
| Telephone No.: |
Mobile no: 9606518838 |
| E-mail: sainathshetty.172@gmail.com |
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| Application fee payment details: |
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| Payment Status: failure |
Payment Mode: Online |
| Amount: ₹ 200 |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 304926097 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049971 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: Shetty Sainath Bhaskar |
| Mother's Name: Harini |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 30 Jul 2002 |
Nationality: Indian |
| Place of Birth: Udupi |
Personal Identification Mark: Mole on right hand |
| Blood Group: O + |
Address for Communication: 3-135 kunjadi house, balakatta garadi , hirebettu udupi karnataka. 3-135 kunjadi house ,balakatta garadi, hirebettu,udupi,karnataka |
| State: Karnataka |
Country: India |
| Pin: 576107 |
City/District: Udupi |
| Mobile no: 9606518838 |
Telephone No. with STD code: |
| Aadhar Card No:386205332221 |
E-mail: sainathshetty.172@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Saritha |
Relationship with candidate: Aunt |
| Parents Date of Birth: 13 Mar 1982 |
Parent's/Guardian's Occupation/Designation: Therapist |
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| Office Address: |
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| Address: Sdm nature cure hospital parika parkala udupi Sdm nature cure hospital parika parkala udupi |
| Country: India |
State: Karnataka |
| City/District: Udupi |
Pin: 576107 |
| Tel: |
Mobile no.: 7406714300 |
| Fax: |
Email: sainathshetty.172@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: Karnataka |
| School: Chandresh lodha memorial high school |
School: Shyamili indp pu college |
| City: Nallasopara |
City: Udupi |
| English %: 86 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 91 |
School/College Code: |
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Centre code: |
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Address of School/College: Shyamili indp pu college, kidiyoor , udupi, karnataka |
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Pin: 576103 |
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Contact Nos: 9606518838 |
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Email: sainathshetty.172@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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| Sports & Extra Curricular Activities: |
| Achievements in Sports and Extra Curricular Activities |
| MONTH / YEAR (MM/YYYY) |
SPORT/ACTIVITY |
LEVEL OF PARTICIPATION |
POSITION |
| 12/2014 |
Taekwondo |
Taluk level |
Third |
| 12/2015 |
Taekwondo |
Taluk level |
First |
| 09/2019 |
LIC quiz competition |
College level |
Second |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: I will utilise my time for preparing myself for sponsorship test , interviews and imucet. |
| Why do you wish to join TMI?: I want to join TMI because it has best faculty and it encourages sports and discipline in students daily routine. Also it has better tie up with many ship companies. |
| What are your hobbies?: Playing cricket, Travelling |
| What are your strengths?: Self confidence , patience, quicklearner. |
| What are your weaknesses?: Straight forward |
| 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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