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: DNS2051544 Name: Sharma Shubham Ramakant
  Address: 9/1, pimpalkar niwas bldg 2nd lane, navaghar road, Mulund east, mumbai 400081, Maharashtra
Telephone No.: Mobile no: 9082891283
E-mail: sshubhamr36@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 309107733
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051544 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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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: DNS2051544
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Sharma Shubham Ramakant
Mother's Name: Asha Ramakant Sharma
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Sep 2002 Nationality: Indian
Place of Birth: Nashik Personal Identification Mark: Mole on left hand
Blood Group: B + Address for Communication: 9/1, pimpalkar niwas bldg 2nd lane, navaghar road, Mulund east, mumbai 400081, Maharashtra
State: Maharashtra Country: India
Pin: 400081 City/District: Mumbai
Mobile no: 9082891283 Telephone No. with STD code:
Aadhar Card No:730593132063 E-mail: sshubhamr36@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Asha Ramakant Sharma Relationship with candidate: Mother
Parents Date of Birth: 04 May 1981 Parent's/Guardian's Occupation/Designation: Housewife
   
Office Address:
   
Address: 9/1, pimpalkar niwas bldg 2nd lane, navaghar road Mulund east, mumbai 400081, Maharashtra
Country: India State: Maharashtra
City/District: Mumbai Pin: 400081
Tel: Mobile no.: 9004070369
Fax: Email: sshubhamr36@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Maharashtra Board: Maharashtra
School: Sou Laxmibai English medium school and Junior college School: Sou laxmibai english medium school and Junior college
City: Mumbai City: Mumbai
English %: 85 Board Roll No./Seat No.:
Aggregate Percentage: 89 School/College Code:
  Centre code:
  Address of School/College: Sou laxmibai english medium school and Junior college, Veer Savarkar road, Deen Dayal nagar, Mulund east, Mumbai 400081, Maharashtra
  Pin: 400081
  Contact Nos:
  Email: soulaxmibai@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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
05/07/2018 American tackle football Varsity Northern California Section Championship Wide receiver
15/02/2019 Varsity Wrestling Northern California Section Championship Varsity Wrestler
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Work for building career in Merchant navy
Why do you wish to join TMI?: Presently, it is the best institue for training, knowledge and placement
What are your hobbies?: Cycling, swimming, reading, excercise
What are your strengths?: Dedication
What are your weaknesses?: Sensitive
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan
 
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

 

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Date ________________

 
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