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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: DNS2051038 |
Name: SANGRAM RANA |
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Address: 4TH LANE BASUDEV NAGAR KHODASINGHI BRAHAMPUR |
| Telephone No.: |
Mobile no: 7751054264 |
| E-mail: sangramrana0908@gmail.com |
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| Application fee payment details: |
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| Payment Status: failure |
Payment Mode: Online |
| Amount: ₹ 200 |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 308216254 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051038 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: SANGRAM RANA |
| Mother's Name: SUGYANI RANA |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 09 Aug 2001 |
Nationality: INDIAN |
| Place of Birth: BHANJANAGAR |
Personal Identification Mark: CUT MARK ON LEFT EYE |
| Blood Group: O + |
Address for Communication: 4TH LANE BASUDEV NAGAR KHODASINGHI BRAHAMPUR |
| State: Orissa |
Country: India |
| Pin: 760010 |
City/District: GANJAM |
| Mobile no: 7751054264 |
Telephone No. with STD code: |
| Aadhar Card No:696585375631 |
E-mail: sangramrana0908@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: BABULA RANA |
Relationship with candidate: FATHER |
| Parents Date of Birth: 10 Jan 1970 |
Parent's/Guardian's Occupation/Designation: DEFENCE |
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| Office Address: |
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| Address: manipur northeast |
| Country: India |
State: Manipur |
| City/District: imphal west |
Pin: 795002 |
| Tel: |
Mobile no.: 6371444844 |
| Fax: |
Email: babularana153788@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: ASSAM RIFLES PUBLIC SCHOOL AGARTALA |
School: ARMY PUBLIC SCHOOL GOPALPUR |
| City: AGARTALA |
City: BRAHAMPUR |
| English %: 86 |
Board Roll No./Seat No.: 6604598 |
| Aggregate Percentage: 87 |
School/College Code: 09714 |
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Centre code: 6136 |
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Address of School/College: ARMY PUBLIC SCHOOL GOPALPUR |
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Pin: 761052 |
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Contact Nos: |
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Email: apsgopalpur@gmail.com |
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Aggregate Percentage: 78 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
77 |
77 |
| Chemistry |
100 |
69 |
69 |
| Mathematics |
100 |
66 |
66 |
| Physics, Chemistry & Mathematics combined Percentage: |
70.67 |
| English |
100 |
77 |
77 |
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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 |
| 01/2017 |
PARADE |
STATE LEVEL |
1ST |
| 10/2018 |
BASKET BALL |
SCHOOL LEVEL |
2ND |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: preparing for exams |
| Why do you wish to join TMI?: i want a adventurous life |
| What are your hobbies?: cube solving |
| What are your strengths?: creativity |
| What are your weaknesses?: spelling mistake |
| 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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