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: DNS2051927 Name: TASKEEN FATHIMA
  Address: VIVEKA NAGAR MARUTHI STORES HASSAN
Telephone No.: Mobile no: 9900660488
E-mail: tarannumfathima200@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 309798563
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051927 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: DNS2051927
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: TASKEEN FATHIMA
Mother's Name: TARANNUM FATHIMA
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Jun 2002 Nationality: INDIAN
Place of Birth: TUMKUR Personal Identification Mark: NO
Blood Group: B + Address for Communication: VIVEKA NAGAR MARUTHI STORES HASSAN
State: Karnataka Country: India
Pin: 573201 City/District: HASSAN
Mobile no: 9900660488 Telephone No. with STD code:
Aadhar Card No:798980855521 E-mail: tarannumfathima200@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: MUJEEB UR RAHAMAN Relationship with candidate: FATHER
Parents Date of Birth: 18 Apr 1976 Parent's/Guardian's Occupation/Designation: PLANTER
   
Office Address:
   
Address: TOLALU ROAD BELUR TALUK AREHALLI HASSAN DIST
Country: India State: Karnataka
City/District: HASSAN Pin: 573101
Tel: Mobile no.: 9980295505
Fax: Email: mujeeburrahaman85@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: Karnataka
School: CHRIST SCHOOL HASSAN School: BRIGADE PU COLLEGE HASSAN
City: HASSAN City: HASSAN
English %: 96 Board Roll No./Seat No.: 154798
Aggregate Percentage: 92 School/College Code: LL215
  Centre code: XC-4211
  Address of School/College: MANACHANAHALLI GATE BELUR ROAD HASSAN
  Pin: 573201
  Contact Nos:
  Email: brigadepucollegehassan@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:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: PREPARING FOR UPCOMING EXAMS
Why do you wish to join TMI?: BECAUSE OF YOUR EXCELLENCE AND PLACEMENTS
What are your hobbies?: EXPLORING NEW PLACES
What are your strengths?: QUICK LEARNER AND VERSATILE
What are your weaknesses?: COMPETATIVE
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 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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