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: DNS2051630 Name: Ashit Kumar priyadarshi
  Address: Road no. 1B ,H.no. 14 shivpuri boring road,Patna Jehanabad P.O. ghoshi, village waina
Telephone No.: Mobile no: 8409723863
E-mail: ashitpriyadarshi@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: 309232773
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051630 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: DNS2051630
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Ashit Kumar priyadarshi
Mother's Name: Sandhya Kumari
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 29 Dec 2002 Nationality: Indian
Place of Birth: Patna Personal Identification Mark: Mole behind right ear
Blood Group: A + Address for Communication: Road no. 1B ,H.no. 14 shivpuri boring road,Patna Jehanabad P.O. ghoshi, village waina
State: Bihar Country: India
Pin: 800023 City/District: Patna
Mobile no: 8409723863 Telephone No. with STD code:
Aadhar Card No:830616763923 E-mail: ashitpriyadarshi@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Anjani kumar Relationship with candidate: Father
Parents Date of Birth: 06 Mar 1977 Parent's/Guardian's Occupation/Designation: Government employee
   
Office Address:
   
Address: Patna Rohtas
Country: India State: Bihar
City/District: Patna Pin: 800023
Tel: Mobile no.: 9525070614
Fax: Email: sandhyakri1985@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: St. Dominic savios high school School: DAV BSEB
City: Patna City: Patna
English %: 92 Board Roll No./Seat No.:
Aggregate Percentage: 90 School/College Code:
  Centre code:
  Address of School/College: Sashtri nagar near energy park,patna
  Pin: 800023
  Contact Nos:
  Email: davpatnazone1@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
10/2018 Karate Cluster 1st
07/2017 Karate International 3rd
03/2019 Karate District 3rd
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Doing mathematics and chemistry
Why do you wish to join TMI?: As TMI is one of its kind in offering a good environment
What are your hobbies?: Playing karate
What are your strengths?: Patience, endurance
What are your weaknesses?: Lack of time management
How do you intend to meet the expenses of this program?: 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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