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: DNS2050744 Name: SHUKLA KUNAL PRADEEP
  Address: BEHIND GOVERNMENT MILK DAIRY SHASTRI NAGAR AKOLA
Telephone No.: Mobile no: 9284909468
E-mail: slmnetworld@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: 306860619
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050744 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: DNS2050744
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: SHUKLA KUNAL PRADEEP
Mother's Name: SANGEETA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Dec 2002 Nationality: INDIAN
Place of Birth: AKOLA Personal Identification Mark: MOLE ON RIGHT HAND ARM
Blood Group: B + Address for Communication: BEHIND GOVERNMENT MILK DAIRY SHASTRI NAGAR AKOLA
State: Maharashtra Country: India
Pin: 444001 City/District: AKOLA
Mobile no: 9284909468 Telephone No. with STD code:
Aadhar Card No:214193341031 E-mail: slmnetworld@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: PRADEEP SHIYARAM SHUKLA Relationship with candidate: FATHER
Parents Date of Birth: 13 Mar 1974 Parent's/Guardian's Occupation/Designation: SELF EMPLOYED
   
Office Address:
   
Address: BEHIND GOVERNMENT MILK DAIRY SHASTRI NAGAR AKOLA
Country: India State: Maharashtra
City/District: AKOLA Pin: 444001
Tel: Mobile no.: 8975139338
Fax: Email: slmnetworld@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Maharashtra Board: Maharashtra
School: HINDU DNYANPEETH CONVENT SCHOOL AKOLA School: N.G. PAVITRAKAR JUNIOR COLLEGE OF SCIENCE AKOLA
City: AKOLA City: AKOLA
English %: 58 Board Roll No./Seat No.:
Aggregate Percentage: 63 School/College Code:
  Centre code:
  Address of School/College: AT. POST. KANSHIVANI, TQ. AKOLA, DIST. AKOLA
  Pin: 444102
  Contact Nos:
  Email: ngpavitrakar@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Spending Time on my Physical Fitness
Why do you wish to join TMI?: It is a Reputed Institute of all over India
What are your hobbies?: Playing Cricket
What are your strengths?: Good in Decision Making
What are your weaknesses?: Stage Fright
How do you intend to meet the expenses of this program?: Bank Loan
 
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 not uploaded
 
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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