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: DNS2051661 Name: KURKUTE RUTIK BALASAHEB
  Address: BABURAONAGAR SHIRUR TAL - SHIRUR
Telephone No.: Mobile no: 7888242880
E-mail: rutikkurkute9@gmail.com  
   
Application fee payment details:  
Payment Status: failure Payment Mode: Online
Amount: ₹ 200 DD Number: -
Issuing Bank: - Transaction Id: 309288905
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051661 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: DNS2051661
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: KURKUTE RUTIK BALASAHEB
Mother's Name: SUREKHA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Nov 2000 Nationality: INDIAN
Place of Birth: MUMBAI Personal Identification Mark: BLACK MOLE ON FACE
Blood Group: O + Address for Communication: BABURAONAGAR SHIRUR TAL - SHIRUR
State: Maharashtra Country: India
Pin: 412210 City/District: PUNE
Mobile no: 7888242880 Telephone No. with STD code:
Aadhar Card No:583782353108 E-mail: rutikkurkute9@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: KURKUTE SUREKHA BALASAHEB Relationship with candidate: MOTHER
Parents Date of Birth: 30 May 1981 Parent's/Guardian's Occupation/Designation: HOUSEWIFE
   
Office Address:
   
Address: NA NA NA
Country: India State: Maharashtra
City/District: PUNE Pin: 412210
Tel: Mobile no.: 9096409621
Fax: Email: rutikkurkute9@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Maharashtra Board: Maharashtra
School: VIDYADHAM PRASHALA SHIRUR School: VIDYADHAM JUNIOR COLLEGE OF SCIENCE SHIRUR
City: SHIRUR City: SHIRUR
English %: 60 Board Roll No./Seat No.: P029454
Aggregate Percentage: 81 School/College Code: 0121
  Centre code: 0121
  Address of School/College: SHIRUR, TAL - SHIRUR, DIST - PUNE
  Pin: 412210
  Contact Nos:
  Email: rutikkurkute9@gmail.com
  Aggregate Percentage: 72
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 61 61
Chemistry 100 61 61
Mathematics 100 60 60
Physics, Chemistry & Mathematics combined Percentage: 60.67
English 100 61 61
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: STUDY IMU CET EXAM
Why do you wish to join TMI?: BEST FOR MARINE
What are your hobbies?: SWIMMING, PLAYING CRICKET
What are your strengths?: HARDWORK
What are your weaknesses?: NA
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
 
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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