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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: DNS2050111 |
Name: Nachiket Purohit |
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Address: A 702 Wembley Estate Rosewood City |
| Telephone No.: |
Mobile no: 7990866110 |
| E-mail: nachiket.purohit18@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 305199130 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050111 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: Nachiket Purohit |
| Mother's Name: Bansi Purohit |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 22 Sep 2001 |
Nationality: Indian |
| Place of Birth: Jamnagar |
Personal Identification Mark: None |
| Blood Group: A + |
Address for Communication: A 702 Wembley Estate Rosewood City |
| State: Haryana |
Country: India |
| Pin: 122001 |
City/District: Gurugram |
| Mobile no: 7990866110 |
Telephone No. with STD code: |
| Aadhar Card No: |
E-mail: nachiket.purohit18@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Haresh Kumar Purohit |
Relationship with candidate: father |
| Parents Date of Birth: 05 Feb 1966 |
Parent's/Guardian's Occupation/Designation: Electrical Engineer/Senior Manager |
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| Office Address: |
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| Address: BPTP Centra One Golf Course Ext Rd, Baharampur Naya, Sector 61, Ghata, Haryana 122102 |
| Country: India |
State: Haryana |
| City/District: Gurugram |
Pin: 122102 |
| Tel: |
Mobile no.: 9810342326 |
| Fax: |
Email: haresh.purohit005@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2017 |
Year of Passing: 2019 |
| Board: CBSE |
Board: CBSE |
| School: Summer Fields School |
School: Summer Fields School |
| City: Gurugram |
City: Gurugram |
| English %: 66 |
Board Roll No./Seat No.: 2631296 |
| Aggregate Percentage: 66 |
School/College Code: 04198 |
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Centre code: 2079 |
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Address of School/College: Dlf Qutub Enclave, Phase I, Block A, Sector 26A, Gurugram, Haryana |
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Pin: 122001 |
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Contact Nos: |
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Email: summerfields_dlf@rediffmail.com |
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Aggregate Percentage: 70 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
71 |
71 |
| Chemistry |
100 |
74 |
74 |
| Mathematics |
100 |
44 |
44 |
| Physics, Chemistry & Mathematics combined Percentage: |
63 |
| English |
100 |
70 |
70 |
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| IMU CET Application Number: |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: Me being improvement student in math I used the year to make my self physically fit by weight training and regular running |
| Why do you wish to join TMI?: TMI being one of the largest maritime institute to provide degree in nautical science TMI also has Excellent pacment record
and is GRADED A1 by dg shipping |
| What are your hobbies?: Weight Training,Table Tennis and listening to music. |
| What are your strengths?: Mentally and Emotionally Tough |
| What are your weaknesses?: Lack Public speaking |
| How do you intend to meet the expenses of this program?: Own Resources |
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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
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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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