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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: DNS2051705 |
Name: Vishnu Kumar |
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Address: Aryanagar Rupaideeh Gonda Village and Post Rupaideeh Aryanagar gonda |
| Telephone No.: 7985589830 |
Mobile no: 8957495446 |
| E-mail: sanjuupadhyay8507@gmail.com |
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| Application fee payment details: |
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| Payment Status: failure |
Payment Mode: Online |
| Amount: ₹ 200 |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 313037438 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051705 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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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: Vishnu Kumar |
| Mother's Name: Shashikanti |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 20 Nov 2002 |
Nationality: Indian |
| Place of Birth: Aryanagar |
Personal Identification Mark: Dark spot on head |
| Blood Group: O + |
Address for Communication: Aryanagar Rupaideeh Gonda Village and Post Rupaideeh Aryanagar gonda |
| State: Uttar Pradesh |
Country: India |
| Pin: 271122 |
City/District: Lucknow |
| Mobile no: 8957495446 |
Telephone No. with STD code: 7985589830 |
| Aadhar Card No:589276396840 |
E-mail: sanjuupadhyay8507@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Anjany Kumar |
Relationship with candidate: Father |
| Parents Date of Birth: 05 Jul 1983 |
Parent's/Guardian's Occupation/Designation: Farmer |
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| Office Address: |
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| Address: Aryanagar Rupaideeh Gonda Village and Post Rupaideeh Aryanagar gonda |
| Country: India |
State: Uttar Pradesh |
| City/District: Gonda |
Pin: 271122 |
| Tel: |
Mobile no.: 7985589830 |
| Fax: |
Email: vishnuupadhyay8507@gmail.com |
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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: Aims international secondary School Gonda |
School: Aims international secondary School Gonda |
| City: Gonda |
City: Gonda |
| English %: 88 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 88 |
School/College Code: |
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Centre code: |
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Address of School/College: Gonda uttar Pradesh |
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Pin: 271001 |
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Contact Nos: |
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Email: sanjuupadhyay8507@gmail.com |
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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 |
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| Chemistry |
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| Mathematics |
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| Physics, Chemistry & Mathematics combined Percentage: |
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| English |
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| IMU CET Application Number: |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: By playing cricket and watching movies |
| Why do you wish to join TMI?: I wish to join TMI because of convincing demonstration of personal effect. |
| What are your hobbies?: Playing chess , watching movies and reading books |
| What are your strengths?: Quick learner, adaptability, team work,hard worker, |
| What are your weaknesses?: Afraid of failure, easily boared, discomfort when work is unfinished |
| How do you intend to meet the expenses of this program?: Own Resources,Bank Loan |
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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 not uploaded
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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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