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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: DNS2051973 |
Name: Nikhil |
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Address: H.NO-157,DEV COLONY,ROHTAK H.NO-157,DEV COLONY,ROHTAK |
| Telephone No.: |
Mobile no: 7082940541 |
| E-mail: nikhilsheoran987@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: 309892639 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051973 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: Nikhil |
| Mother's Name: Suman lata |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 26 Aug 2001 |
Nationality: Indian |
| Place of Birth: Rohtak |
Personal Identification Mark: Mark on forhead |
| Blood Group: O - |
Address for Communication: H.NO-157,DEV COLONY,ROHTAK H.NO-157,DEV COLONY,ROHTAK |
| State: Haryana |
Country: India |
| Pin: 124001 |
City/District: Rohtak |
| Mobile no: 7082940541 |
Telephone No. with STD code: |
| Aadhar Card No:552704615594 |
E-mail: nikhilsheoran987@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Suman lata |
Relationship with candidate: Mother |
| Parents Date of Birth: 01 Sep 1971 |
Parent's/Guardian's Occupation/Designation: Professor |
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| Office Address: |
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| Address: Kila Road,Rohtak Kila Road,Rohtak |
| Country: India |
State: Haryana |
| City/District: Rohtak |
Pin: 124001 |
| Tel: |
Mobile no.: 9416494948 |
| Fax: |
Email: suman1970malik@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2017 |
Year of Passing: 2019 |
| Board: CBSE |
Board: CBSE |
| School: U.C.S |
School: R.P.S |
| City: Rohtak |
City: Mohindergarh |
| English %: 76 |
Board Roll No./Seat No.: 2666449 |
| Aggregate Percentage: 70 |
School/College Code: 530286 |
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Centre code: 530765 |
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Address of School/College: Khatod, Mohindergarh |
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Pin: 123028 |
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Contact Nos: |
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Email: rpskhatod@gmail.com |
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Aggregate Percentage: 91 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
81 |
81 |
| Chemistry |
100 |
95 |
95 |
| Mathematics |
100 |
95 |
95 |
| Physics, Chemistry & Mathematics combined Percentage: |
90.33 |
| English |
100 |
86 |
86 |
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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 ?: I will prepare for the interview and imucet exam |
| Why do you wish to join TMI?: I want to join TMI. Because it is one the most reputed institute around the globe and think i will be able to learn a great deal of things by studying in this campus |
| What are your hobbies?: Collecting foreign currency |
| What are your strengths?: Good at making new friends, And Easily adjusts with new surroundings |
| What are your weaknesses?: Gets sad when some close one lies |
| 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
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Class XII admit card not uploaded
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Class XII marksheet
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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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