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: DNS2051572 Name: Choudhary Ravindra Roshan
  Address: 203 A-wing Anushka apartment alandi road Moshi pune 203 second floor A-wing
Telephone No.: Mobile no: 9067702854
E-mail: ravindra9258choudhary@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 323908482
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051572 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: DNS2051572
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Choudhary Ravindra Roshan
Mother's Name: Virmati
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Jun 2001 Nationality: Indian
Place of Birth: Jind Personal Identification Mark: Mole on neck
Blood Group: O + Address for Communication: 203 A-wing Anushka apartment alandi road Moshi pune 203 second floor A-wing
State: Maharashtra Country: India
Pin: 412105 City/District: Pune
Mobile no: 9067702854 Telephone No. with STD code:
Aadhar Card No:410815195329 E-mail: ravindra9258choudhary@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Roshan Relationship with candidate: Father
Parents Date of Birth: 15 May 1965 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: shiv shakti road carrier Office no.2, gate no. 171/1, opposite to Indrayani Nursery, Post office Kuruli, Pune - Nashik Highway, chimbali phata, taluka ked, district -Pune - 410501 shiv shakti road carriers ,Office no.2, gate no.171/1
Country: India State: Maharashtra
City/District: Pune Pin: 410501
Tel: Mobile no.: 9325383753
Fax: Email: ssrcchoudharyroshanlal9258@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: Maharashtra
School: Priyadarshini School: Gayatri
City: Pune City: Pune
English %: 70 Board Roll No./Seat No.: P026692
Aggregate Percentage: 66 School/College Code: 1105037
  Centre code: 0076
  Address of School/College: Gayatri Jr.college gandharv nagari Moshi Pune
  Pin: 412105
  Contact Nos:
  Email: gayatriems@gmail.com
  Aggregate Percentage: 60
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 36 36
Chemistry 100 56 56
Mathematics 100 62 62
Physics, Chemistry & Mathematics combined Percentage: 51.33
English 100 51 51
   
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
09/2016 IT Wizard plus programme Student first grade
11/2016 Scout camp Vice captain 3 rank
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: preparing for Marshal art and CET
Why do you wish to join TMI?: I love the faculty and the sports activity
What are your hobbies?: Music
What are your strengths?: Stubborn
What are your weaknesses?: Patience
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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