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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: DNS2050131 |
Name: Patil Rahul Rajesh |
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Address: B/1401 , Gokul Concorde , Dattani Park , Thakur Village , Kandivali East , Mumbai |
| Telephone No.: 02228846104 |
Mobile no: 9820420087 |
| E-mail: nr1_rajesh123@yahoo.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: 305212416 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050131 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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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: Patil Rahul Rajesh |
| Mother's Name: Nilaxi Rajesh Patil |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 23 Oct 2001 |
Nationality: Indian |
| Place of Birth: Thane |
Personal Identification Mark: Birth mark on stomach |
| Blood Group: O + |
Address for Communication: B/1401 , Gokul Concorde , Dattani Park , Thakur Village , Kandivali East , Mumbai |
| State: Maharashtra |
Country: India |
| Pin: 400101 |
City/District: Mumbai |
| Mobile no: 9820420087 |
Telephone No. with STD code: 02228846104 |
| Aadhar Card No:391758499159 |
E-mail: nr1_rajesh123@yahoo.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Rajesh Patil |
Relationship with candidate: Father |
| Parents Date of Birth: 15 Nov 1969 |
Parent's/Guardian's Occupation/Designation: Marine Engineer |
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| Office Address: |
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| Address: The Great Eastern Shipping Co. Ltd . ,Ocean House, 134/A, Dr. Annie Besant Road , Worli |
| Country: India |
State: Maharashtra |
| City/District: Mumbai |
Pin: 400018 |
| Tel: |
Mobile no.: 9321291798 |
| Fax: |
Email: nr1_rajesh123@yahoo.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: ISCE |
Board: Maharashtra |
| School: Thakur Public School |
School: Thakur College of Science and Commerce |
| City: Mumbai |
City: Mumbai |
| English %: 85 |
Board Roll No./Seat No.: M008659 |
| Aggregate Percentage: 78 |
School/College Code: 27230700188 |
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Centre code: 0956 |
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Address of School/College: Shyamnarayan Thakur Marg , Kandivali East , Mumbai |
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Pin: 400101 |
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Contact Nos: 28462565 |
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Email: tcsc@tcsc.org.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 |
47 |
47 |
| Chemistry |
100 |
82 |
82 |
| Mathematics |
100 |
94 |
94 |
| Physics, Chemistry & Mathematics combined Percentage: |
74.33 |
| English |
100 |
67 |
67 |
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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 ?: Preparing For IMU-CET exam and reading books . |
| Why do you wish to join TMI?: TMI is a reputed College |
| What are your hobbies?: Reading and Swimming |
| What are your strengths?: I am fitness conscious |
| What are your weaknesses?: I tend to rush through tasks because i want to get them done quickly |
| 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
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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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