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)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2050350 Name: YASH CHAURASIA
  Address: SAI BABA GOLDI VASTRA BHANDAR MADHINATH BAREILLY
Telephone No.: Mobile no: 9634489408
E-mail: CHAURASIA251198@GMAIL.COM  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 306037307
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050350 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 
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.

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

 
  Dossier ID: DNS2050350
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: YASH CHAURASIA
Mother's Name: NEETA CHAURASIA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 03 Aug 2001 Nationality: INDIAN
Place of Birth: BAREILLY Personal Identification Mark: MARK ON LEFT HAND
Blood Group: B + Address for Communication: SAI BABA GOLDI VASTRA BHANDAR MADHINATH BAREILLY
State: Uttar Pradesh Country: India
Pin: 243001 City/District: BAREILLY
Mobile no: 9634489408 Telephone No. with STD code:
Aadhar Card No:259591490227 E-mail: CHAURASIA251198@GMAIL.COM
 
Guardian's Particulars:
 
Name of Parent/Guardian: ANOOP KUMAR CHAURASIA Relationship with candidate: FATHER
Parents Date of Birth: 05 Jul 1978 Parent's/Guardian's Occupation/Designation: GOVERNMENT SERVICE
   
Office Address:
   
Address: ITAUA SUKHDEV PUR BUDAUN ROAD BAREILLY
Country: India State: Uttar Pradesh
City/District: BAREILLY Pin: 243001
Tel: Mobile no.: 9675891951
Fax: Email: CNEETAC@GMAIL.COM
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: M R S PUBLIC SCHOOL PILIBHIT BYPASS ROAD School: M R S PUBLIC SCHOOL PILLIBHIT BYPASS ROAD
City: BAREILLY City: BAREILLY
English %: 86 Board Roll No./Seat No.: 5642988
Aggregate Percentage: 78 School/College Code: 54403
  Centre code: 5095
  Address of School/College: PILIBHIT BYPASS BAREILLY
  Pin: 243001
  Contact Nos:
  Email: SAURABHASTRA@GMAIL.COM
  Aggregate Percentage: 72
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 63 63
Chemistry 100 68 68
Mathematics 100 73 73
Physics, Chemistry & Mathematics combined Percentage: 68
English 100 77 77
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: STUDY
Why do you wish to join TMI?: FOR POSITIVE FEEDBACK
What are your hobbies?: READING BOOKS
What are your strengths?: HONEST
What are your weaknesses?: TRUST EASILY
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet
 
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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