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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: DNS2052058 |
Name: Devonshu Gupta |
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Address: 563/478, Shahganj |
| Telephone No.: |
Mobile no: 9453460359 |
| E-mail: guptadevonshu@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: 310142846 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052058 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: Devonshu Gupta |
| Mother's Name: Rachana Gupta |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 14 Dec 2001 |
Nationality: Indian |
| Place of Birth: Faizabad |
Personal Identification Mark: Mole on Chest |
| Blood Group: O + |
Address for Communication: 563/478, Shahganj |
| State: Uttar Pradesh |
Country: India |
| Pin: 211003 |
City/District: Prayagraj |
| Mobile no: 9453460359 |
Telephone No. with STD code: |
| Aadhar Card No: |
E-mail: guptadevonshu@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Rajesh Kumar Gupta |
Relationship with candidate: Father |
| Parents Date of Birth: 30 Aug 1965 |
Parent's/Guardian's Occupation/Designation: Self Employed |
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| Office Address: |
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| Address: 563/478, Shahganj |
| Country: India |
State: Uttar Pradesh |
| City/District: Prayagraj |
Pin: 211003 |
| Tel: |
Mobile no.: 9415728281 |
| Fax: |
Email: rajonline478@rediffmail.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: ISCE |
Board: ISCE |
| School: Boys High School |
School: Boys High School |
| City: Prayagraj |
City: Prayagraj |
| English %: 72 |
Board Roll No./Seat No.: 6711168 |
| Aggregate Percentage: 76 |
School/College Code: UP009 |
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Centre code: 2201606 |
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Address of School/College: 4, P.D. Tandon Road
Post Box. No. 4
Prayagraj |
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Pin: 211001 |
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Contact Nos: |
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Email: principal@boyshighschool.com |
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Aggregate Percentage: 65 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
77 |
77 |
| Chemistry |
100 |
60 |
60 |
| Mathematics |
100 |
43 |
43 |
| Physics, Chemistry & Mathematics combined Percentage: |
60 |
| English |
100 |
75 |
75 |
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| IMU CET Application Number: CET20U72660 |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: Prepration for Merchany Navy Exam |
| Why do you wish to join TMI?: Other than being prime institute for merchant navy courses it also provide excellent education and job opportunities for those who see their carrer on ships. |
| What are your hobbies?: Travelling |
| What are your strengths?: Versatility |
| What are your weaknesses?: Easily trust other peoples |
| 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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