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: DNS2051270 Name: PATANKAR IBRAHIM SAMEER
  Address: B/304 ASMITA ORCHID 1 NAYA NAGAR MIRA ROAD EAST
Telephone No.: Mobile no: 7400132232
E-mail: ibrahimpatankar211001@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: 308603247
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051270 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: DNS2051270
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PATANKAR IBRAHIM SAMEER
Mother's Name: KANEEZ SAMEER PATANKAR
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Aug 2001 Nationality: INDIAN
Place of Birth: MUMBAI Personal Identification Mark: STICH ON FOREHEAD
Blood Group: O + Address for Communication: B/304 ASMITA ORCHID 1 NAYA NAGAR MIRA ROAD EAST
State: Maharashtra Country: India
Pin: 401107 City/District: THANE
Mobile no: 7400132232 Telephone No. with STD code:
Aadhar Card No:511009567404 E-mail: ibrahimpatankar211001@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SAMEER IBRAHIM PATANKAR Relationship with candidate: FATHER
Parents Date of Birth: 24 Jun 1972 Parent's/Guardian's Occupation/Designation: SEAMAN
   
Office Address:
   
Address: NAYA NAGAR MIRA ROAD EAST
Country: India State: Maharashtra
City/District: THANE Pin: 401107
Tel: Mobile no.: 9987949572
Fax: Email: kaneezpatankar786@yahoo.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Maharashtra Board: Maharashtra
School: N.H ENGLISH ACADEMY School: ROYAL COLLEGE
City: MIRA ROAD City: MIRA ROAD
English %: 66 Board Roll No./Seat No.: M027405
Aggregate Percentage: 74 School/College Code: 875
  Centre code: 1401
  Address of School/College: PENKAR PADA, MIRA ROAD
  Pin: 401107
  Contact Nos:
  Email: info@royalcollegemiraroad.edu.in
  Aggregate Percentage: 64
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 63 63
Chemistry 100 60 60
Mathematics 100 78 78
Physics, Chemistry & Mathematics combined Percentage: 67
English 100 62 62
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: PREPARATION OF ENTRANCE EXAM
Why do you wish to join TMI?: ELDER BROTHER REFER TO JOIN TMI
What are your hobbies?: FOOTBALL
What are your strengths?: SELF CONFIDENCE
What are your weaknesses?: I HAVE TROUBLE TO SAY NO
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
 
Declaration

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

Signature of Candidate

 

___________________

Date ________________

 
Print Summary and Application Form