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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: DNS2051301 |
Name: Devansh Bisht |
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Address: House number 9B, block C5c Janakpuri New Delhi |
| Telephone No.: |
Mobile no: 8750779669 |
| E-mail: dev2002bisht@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 308626541 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051301 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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___________________ |
___________________ |
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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: Devansh Bisht |
| Mother's Name: Hema Bisht |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 20 Jan 2002 |
Nationality: Indian |
| Place of Birth: New Delhi |
Personal Identification Mark: scar above left eye |
| Blood Group: B + |
Address for Communication: House number 9B, block C5c Janakpuri New Delhi |
| State: Delhi |
Country: India |
| Pin: 110058 |
City/District: New Delhi |
| Mobile no: 8750779669 |
Telephone No. with STD code: |
| Aadhar Card No:273852719910 |
E-mail: dev2002bisht@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Nandan Singh |
Relationship with candidate: Father |
| Parents Date of Birth: 13 May 1968 |
Parent's/Guardian's Occupation/Designation: Service |
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| Office Address: |
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| Address: 119-120, first floor gagandeep building Ranjendra Place New Delhi |
| Country: India |
State: Delhi |
| City/District: New Delhi |
Pin: 110008 |
| Tel: |
Mobile no.: 9540001486 |
| Fax: |
Email: nsbisht1968@yahoo.in |
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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: St.Gregorios School |
School: St.Gregorios School |
| City: New Delhi |
City: New Delhi |
| English %: 79 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 85 |
School/College Code: |
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Centre code: |
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Address of School/College: Gregorios Nagar, sector 11, Dwarka, New delhi |
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Pin: 110075 |
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Contact Nos: |
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Email: principalsgs@yahoo.co.in |
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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 |
| 08/2017 |
Badminton |
zonal |
third |
| 08/2018 |
badminton |
zonal |
second |
| 08/2019 |
badminton |
zonal |
second |
| 12/2019 |
movie making |
interschool |
third |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: After the commencement of board exams, I am very much forward in seeking hobby classes. I along my friends are planning to go on trip to refresh ourselves. I will also prepare for the upcoming entrance examinations. |
| Why do you wish to join TMI?: I want to join TMI because I think that the institution will build a gentleman out of me, it would build and strengthen the base for my career |
| What are your hobbies?: i like to play badminton, cricket and volleyball. I like sketching, playing guitar and photography. |
| What are your strengths?: I am punctual, goal oriented and optimistic. I remain cool minded even under pressurised conditions and in hard times. |
| What are your weaknesses?: I am less of an extrovert and sometimes finds it difficult to make friends who does not share a common interest. |
| 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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