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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: DNS2049975 |
Name: harshpreet singh khattra |
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Address: near bank of india village khattra chuharam post office-khattra chuharam |
| Telephone No.: |
Mobile no: 7087065971 |
| E-mail: khattra257@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 304988793 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049975 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: harshpreet singh khattra |
| Mother's Name: gurpreet kaur |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 22 Sep 2002 |
Nationality: Indian |
| Place of Birth: khanna |
Personal Identification Mark: cut on left thiegh |
| Blood Group: B + |
Address for Communication: near bank of india village khattra chuharam post office-khattra chuharam |
| State: Punjab |
Country: India |
| Pin: 141118 |
City/District: ludhiana |
| Mobile no: 7087065971 |
Telephone No. with STD code: |
| Aadhar Card No:684804966650 |
E-mail: khattra257@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: rajinder singh |
Relationship with candidate: father |
| Parents Date of Birth: 02 Apr 1976 |
Parent's/Guardian's Occupation/Designation: job in private bus company |
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| Office Address: |
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| Address: near bank of india village-khattra chuharam post office-khattra chuharam |
| Country: India |
State: Punjab |
| City/District: ludhiana |
Pin: 141118 |
| Tel: |
Mobile no.: 9814065971 |
| Fax: |
Email: khattrapal777@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: CBSE |
Board: Punjab |
| School: sant isher singh ji memorial public school |
School: baba gurmukh singh baba uttam singh sen sec school |
| City: ludhiana |
City: khadur sahib |
| English %: 72 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 69 |
School/College Code: |
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Centre code: |
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Address of School/College: khadur sahib to raiya road,khadur sahib,tarntaran.punjab |
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Pin: 143117 |
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Contact Nos: |
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Email: nsikhi@yahoo.in |
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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 |
75 |
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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 |
| 12/2016 |
hockey |
district |
first |
| 10/2018 |
basketball |
school level |
second |
| 05/2019 |
lecturate |
school level |
second |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: by taking training of swimming and english couses |
| Why do you wish to join TMI?: to become an officer in merchant navy and i also like to travel |
| What are your hobbies?: reading novels, listening music,searching about automobliles and amazing facts |
| What are your strengths?: friendly,helpful |
| What are your weaknesses?: low confidence |
| How do you intend to meet the expenses of this program?: Other - my father money from his boss |
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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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