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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: DNS2050929 |
Name: Ashmit kashyap |
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Address: 44/13, GALI 1, HUSSAINPURA WEST |
| Telephone No.: 9877971871 |
Mobile no: 8360542753 |
| E-mail: ashmitkashyap0217@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: 307537135 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050929 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: Ashmit kashyap |
| Mother's Name: Priti kashyap |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 17 Feb 2002 |
Nationality: Indian |
| Place of Birth: Amritsar |
Personal Identification Mark: Black dot on right shoulder |
| Blood Group: B + |
Address for Communication: 44/13, GALI 1, HUSSAINPURA WEST |
| State: Punjab |
Country: India |
| Pin: 143001 |
City/District: amritsar |
| Mobile no: 8360542753 |
Telephone No. with STD code: 9877971871 |
| Aadhar Card No: |
E-mail: ashmitkashyap0217@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Parshotam kumar kashyap |
Relationship with candidate: Father |
| Parents Date of Birth: 25 May 1972 |
Parent's/Guardian's Occupation/Designation: Accountant |
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| Office Address: |
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| Address: S. no 3 shanti bhawan pakki gali near old improvement trust |
| Country: India |
State: Punjab |
| City/District: amritsar |
Pin: 143001 |
| Tel: |
Mobile no.: 9877971871 |
| Fax: |
Email: parshottamkumar72@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2018 |
Year of Passing: 2020 |
| Board: CBSE |
Board: CBSE |
| School: Bhartiya vidhya bhavan SL public school |
School: Bhartiya vidhya bhavan SL public school |
| City: amritsar |
City: amritsar |
| English %: 79 |
Board Roll No./Seat No.: 13603990 |
| Aggregate Percentage: 79 |
School/College Code: 20105 |
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Centre code: 2009 |
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Address of School/College: shiwala road |
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Pin: 143001 |
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Contact Nos: 9877971871 |
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Email: parshottamkumar72@gmail.com |
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Aggregate Percentage: |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
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| Chemistry |
100 |
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| Mathematics |
100 |
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| Physics, Chemistry & Mathematics combined Percentage: |
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| English |
100 |
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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 |
| 05/2017 |
chess |
district |
Second |
| 05/2016 |
chess |
district |
Third |
| 09/2017 |
chess |
Punjab State |
Third |
| 07/2017 |
chess |
Punjab state |
Eighth |
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| Vocational and Training Courses undertaken: |
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| MONTH / YEAR (MM/YYYY) |
COURSE |
COURSE DURATION |
| 11/2013 |
Hindustan Scout and Guides |
4 days |
| 09/2017 |
Home nurshing |
1 day |
| 08/2017 |
First aid |
1 day |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: gyming and swimming |
| Why do you wish to join TMI?: good institute |
| What are your hobbies?: playing cricket , chess |
| What are your strengths?: remembering things |
| What are your weaknesses?: high places |
| 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 not uploaded
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Class XII admit card
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Class XII marksheet not uploaded
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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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