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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: DNS2050387 |
Name: Aniket Upadhyay |
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Address: Flat No.501 L.G Towers Jawaharnagar , Sriharipuram Malkapuram Post |
| Telephone No.: |
Mobile no: 9985479460 |
| E-mail: aniups01@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: 306187073 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050387 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: Aniket Upadhyay |
| Mother's Name: Malti Upadhyay |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 24 Mar 2001 |
Nationality: Indian |
| Place of Birth: Vizag |
Personal Identification Mark: Mole on left side of nose |
| Blood Group: O + |
Address for Communication: Flat No.501 L.G Towers Jawaharnagar , Sriharipuram Malkapuram Post |
| State: Andhra Pradesh |
Country: India |
| Pin: 530011 |
City/District: Visakhapatnam |
| Mobile no: 9985479460 |
Telephone No. with STD code: |
| Aadhar Card No: |
E-mail: aniups01@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Sanjay Kumar Upadhyay |
Relationship with candidate: Father |
| Parents Date of Birth: 15 Jan 1977 |
Parent's/Guardian's Occupation/Designation: Ex Indian Navy |
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| Office Address: |
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| Address: Naval Dockyard Scindia |
| Country: India |
State: Andhra Pradesh |
| City/District: Visakhapatnam |
Pin: 530005 |
| Tel: |
Mobile no.: 9010382180 |
| Fax: |
Email: aniketupadhyay2403@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 Vidyalaya No.1 Nausenabaugh |
School: Kendriya Vidyalaya No.1 Nausenabaugh |
| City: Visakhapatnam |
City: Visakhapatnam |
| English %: 90 |
Board Roll No./Seat No.: 4656194 |
| Aggregate Percentage: 84 |
School/College Code: 40015 |
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Centre code: 4591 |
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Address of School/College: Kendriya Vidyalaya No.1 Nausenabaugh , Scindia , Visakhapatnam |
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Pin: 530005 |
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Contact Nos: |
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Email: kv1nausenabaugh@yahoo.co.in |
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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 |
79 |
79 |
| Chemistry |
100 |
68 |
68 |
| Mathematics |
100 |
55 |
55 |
| Physics, Chemistry & Mathematics combined Percentage: |
67.33 |
| English |
100 |
84 |
84 |
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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 |
Football |
Interhouse |
2nd Runner up |
| 12/2017 |
Football |
Interhouse |
Runner Up |
| 12/2017 |
Basketball |
Interhouse |
Runner Up |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: I would like to work on improving my communication skills and would go for outdoor sports activties . I would also explore new places arround me. |
| Why do you wish to join TMI?: I wish to join TMI because of it has good teaching faculty,latest equipments and good placements. TMI also hold a good reputation in the field of marine education. |
| What are your hobbies?: My hobbies are listening music and playing outdoor sports. |
| What are your strengths?: I am very good at my communication skills and can interact with anybody. I can also adjust in any situation and can handle it peacefully. |
| What are your weaknesses?: I am very friendly in nature and easily trusts my friends. |
| How do you intend to meet the expenses of this program?: Bank Loan |
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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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