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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: DNS2050276 |
Name: ROHAN GODARA |
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Address: H.NO357/86, STREET NO. 16A HANUMAN MANDIR ROAD, ASHOK VIHAR PHASE-2 GURUGRAM HARYANA |
| Telephone No.: |
Mobile no: 9818871701 |
| E-mail: rohangodara117@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: 305791336 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050276 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: ROHAN GODARA |
| Mother's Name: BOBBY GODARA |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 22 Nov 2001 |
Nationality: INDIAN |
| Place of Birth: JHAJJAR |
Personal Identification Mark: MOLE ON LEFT SIDE OF NOSE |
| Blood Group: AB + |
Address for Communication: H.NO357/86, STREET NO. 16A HANUMAN MANDIR ROAD, ASHOK VIHAR PHASE-2 GURUGRAM HARYANA |
| State: Haryana |
Country: India |
| Pin: 122001 |
City/District: GURGAON |
| Mobile no: 9818871701 |
Telephone No. with STD code: |
| Aadhar Card No:964949343485 |
E-mail: rohangodara117@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: RAJ SINGH |
Relationship with candidate: FATHER |
| Parents Date of Birth: 01 Dec 1976 |
Parent's/Guardian's Occupation/Designation: REGIONAL MANAGER AT ECOM EXPRESS |
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| Office Address: |
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| Address: ECOM EXPRESS PVT. LTD. , NEAR HIRA PUBLIC SCHOOL NEW DELHI |
| Country: India |
State: Delhi |
| City/District: DELHI |
Pin: 110037 |
| Tel: |
Mobile no.: 9718416880 |
| Fax: |
Email: rajgodara117@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: KENDRIYA VIDHALAYA |
School: KENDRIYA VIDHALAYA |
| City: GURUGRAM |
City: GURUGRAM |
| English %: 84 |
Board Roll No./Seat No.: 2628769 |
| Aggregate Percentage: 89 |
School/College Code: 04025 |
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Centre code: 2073 |
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Address of School/College: KENDRIYA VIDHALAYA, SECTOR-14, GURUGRAM |
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Pin: 122001 |
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Contact Nos: |
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Email: kvgurgaonno1@gmail.com |
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Aggregate Percentage: 72 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
65 |
65 |
| Chemistry |
100 |
70 |
70 |
| Mathematics |
100 |
33 |
33 |
| Physics, Chemistry & Mathematics combined Percentage: |
56 |
| English |
100 |
66 |
66 |
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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 |
| 03/2018 |
inter school swimming championship |
school level |
2nd |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: BY IMPROVING MY SOFT SKILLS AND GAINING KNOWLEDGE ABOUT SHIPPING INDUSTRY |
| Why do you wish to join TMI?: BECAUSE IT IS THE TOP SHIPPING INSTITUTE |
| What are your hobbies?: CYCLING, SWIMMING AND READIND ABOUT OCEANOGRAPHY |
| What are your strengths?: POSITIVE ATTITUDE/HARDWORK, ANALYTICAL APPROACH |
| What are your weaknesses?: GOT QUITE IRRITATED WHEN TASKS ASSIGNED ARE NOT COMLETED ON TIME |
| 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 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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