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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: DNS2051954 |
Name: Rahul jaiswal |
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Address: SECL DHARAM COLONEY M/62 CHHAL Post-Chandrasekharpur ,edu, dist-raigarh TH-dharamjaigarh |
| Telephone No.: |
Mobile no: 9285382903 |
| E-mail: rahuljaiswal0653@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 322635072 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051954 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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___________________ |
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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: Rahul jaiswal |
| Mother's Name: Sarita jaiswal |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 03 Apr 2002 |
Nationality: Indian |
| Place of Birth: Kharsia |
Personal Identification Mark: Mole on centre of nose |
| Blood Group: O + |
Address for Communication: SECL DHARAM COLONEY M/62 CHHAL Post-Chandrasekharpur ,edu, dist-raigarh TH-dharamjaigarh |
| State: Chattisgarh |
Country: India |
| Pin: 496665 |
City/District: Raigarh |
| Mobile no: 9285382903 |
Telephone No. with STD code: |
| Aadhar Card No:763148580768 |
E-mail: rahuljaiswal0653@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Ramlal jaiswal |
Relationship with candidate: Father |
| Parents Date of Birth: 19 Jul 1968 |
Parent's/Guardian's Occupation/Designation: SECL employee |
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| Office Address: |
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| Address: SECL DHARAM COLONEY M/62 CHHAL Chandrasekharpur edu |
| Country: India |
State: Chattisgarh |
| City/District: Raigarh |
Pin: 496665 |
| Tel: |
Mobile no.: 9399092934 |
| Fax: |
Email: ramlaljaiswal0a@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: DAV public school SECL CHHAL |
School: DAV public school SECL CHHAL |
| City: Nawapara CHHAL |
City: Nawapara CHHAL |
| English %: 71 |
Board Roll No./Seat No.: 12663629 |
| Aggregate Percentage: 63 |
School/College Code: 15052 |
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Centre code: 1873 |
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Address of School/College: SECL CHHAL DISTT. RAIGARH CHHATTISGARH for |
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Pin: 496665 |
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Contact Nos: 277707 |
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Email: davchhal2007@rediffmail.com |
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Aggregate Percentage: 86 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
89 |
89 |
| Chemistry |
100 |
92 |
92 |
| Mathematics |
100 |
76 |
76 |
| Physics, Chemistry & Mathematics combined Percentage: |
85.67 |
| English |
100 |
81 |
81 |
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| IMU CET Application Number: CET20U87012 |
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| Sports & Extra Curricular Activities: |
| Achievements in Sports and Extra Curricular Activities |
| MONTH / YEAR (MM/YYYY) |
SPORT/ACTIVITY |
LEVEL OF PARTICIPATION |
POSITION |
| 12/2018 |
Volleyball match |
School level |
Runner |
| 11/2018 |
Football match |
School level |
2nd position |
| 01/2014 |
6th all India maths science talent examination |
National level |
4th position |
| 01/2015 |
National handwriting and colouring contest 2014 |
National level |
Runner |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for imucet and giving sponsorship test |
| Why do you wish to join TMI?: Good placement and supportive environment |
| What are your hobbies?: Making friends |
| What are your strengths?: I am a good multitasker.In my school.i was a part of Cricket and volleyball.i also organised school cultural festivals But I still managed to get good marks/grades all through my final exam. |
| What are your weaknesses?: My inability to say no puts me under a lot of stress at times.however I am learning to say No so that I can focus more productive tasks |
| How do you intend to meet the expenses of this program?: Own Resources |
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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
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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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