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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: DNS2052008 |
Name: Kedar Kailash Mundhe |
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Address: B-15, Sai Pooja, Plot No. 40, Sector-5, Kharghar, Navi Mumbai. |
| Telephone No.: |
Mobile no: 9819316184 |
| E-mail: kedarmundhe190@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 309972082 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052008 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: Kedar Kailash Mundhe |
| Mother's Name: Komal Kailash Mundhe |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 30 Dec 2001 |
Nationality: Indian |
| Place of Birth: Thane |
Personal Identification Mark: mole on left foot |
| Blood Group: B + |
Address for Communication: B-15, Sai Pooja, Plot No. 40, Sector-5, Kharghar, Navi Mumbai. |
| State: Maharashtra |
Country: India |
| Pin: 410210 |
City/District: Navi Mumbai |
| Mobile no: 9819316184 |
Telephone No. with STD code: |
| Aadhar Card No:691489921440 |
E-mail: kedarmundhe190@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Komal Kailash Mundhe |
Relationship with candidate: Mother |
| Parents Date of Birth: 02 May 1972 |
Parent's/Guardian's Occupation/Designation: Nurse |
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| Office Address: |
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| Address: TATA Memorial Hospital, ACTREC, Sector-22, Utsav Chowk, Owe Camp, Kharghar, Navi Mumbai. |
| Country: India |
State: Maharashtra |
| City/District: Navi Mumbai |
Pin: 410210 |
| Tel: |
Mobile no.: 9769232021 |
| Fax: |
Email: sheetalmundhe96@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: Bal Bharati Public School |
School: Greenfingers Global School |
| City: Kharghar |
City: Kharghar |
| English %: 85 |
Board Roll No./Seat No.: 4660230 |
| Aggregate Percentage: 76 |
School/College Code: 45076 |
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Centre code: 4603 |
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Address of School/College: Plot no. 9, Near Shilp Chowk, Sector 12, Kharghar, Navi Mumbai. |
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Pin: 410210 |
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Contact Nos: 02227745420 |
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Email: admin@greenfingersglobalschool.com |
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Aggregate Percentage: 66 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
59 |
59 |
| Chemistry |
100 |
63 |
63 |
| Mathematics |
100 |
44 |
44 |
| Physics, Chemistry & Mathematics combined Percentage: |
55.33 |
| English |
100 |
92 |
92 |
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| IMU CET Application Number: |
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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 |
| 11/2018 |
100M |
School Annual Meet |
1 |
| 11/2018 |
200M |
School Annual Meet |
1 |
| 11/2018 |
400M |
School Annual Meet |
1 |
| 11/2018 |
Relay |
School Annual Meet |
1 |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: Reading, Trekking, Painting, Traveling, Gathering Knowledge. |
| Why do you wish to join TMI?: Great Faculty and Infrastructure. |
| What are your hobbies?: Trekking, Drawing, Painting, Reading. |
| What are your strengths?: Working under pressure and Quick learner. |
| What are your weaknesses?: lethargic. |
| 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 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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