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: DNS2051063 Name: ABHILASH SATAPATHY
  Address: VPO GHOSAR TEHSIL RK NAGAR
Telephone No.: Mobile no: 8790028895
E-mail: badalsatapathy03@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: 308264020
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051063 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________

   
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: DNS2051063
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: ABHILASH SATAPATHY
Mother's Name: MAHASWETA SATAPATHY
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 03 May 2003 Nationality: INDIAN
Place of Birth: ANGUL Personal Identification Mark: MOLE ON BELOW OF CHEST
Blood Group: B + Address for Communication: VPO GHOSAR TEHSIL RK NAGAR
State: Orissa Country: India
Pin: 759126 City/District: ANGUL
Mobile no: 8790028895 Telephone No. with STD code:
Aadhar Card No:389929363291 E-mail: badalsatapathy03@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: ALOK KUMAR SATAPATHY Relationship with candidate: FATHER
Parents Date of Birth: 15 Jul 1976 Parent's/Guardian's Occupation/Designation: ARMY
   
Office Address:
   
Address: VPO GHOSAR TEHSIL RK NAGAR
Country: India State: Orissa
City/District: ANGUL Pin: 759126
Tel: Mobile no.: 7710538895
Fax: Email: badalsatapathy03@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: ARMY PUBLIC SCHOOL School: ARMY PUBLIC SCHOOL
City: PATIALA City: PATIALA
English %: 85 Board Roll No./Seat No.:
Aggregate Percentage: 78 School/College Code:
  Centre code:
  Address of School/College: TARAPORE ENCLAVE PATIALA
  Pin: 147001
  Contact Nos:
  Email: aksatpathy891@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 ?: continue as regular to achieve the goal.
Why do you wish to join TMI?: looking for good practice for my higher studies
What are your hobbies?: outdoor games such as football and basket ball
What are your strengths?: Confident, Punctual
What are your weaknesses?: Shy
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 not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

___________________

Date ________________

 
Print Summary and Application Form