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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: DNS2052086 |
Name: SUMAN SAMANTA |
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Address: H.N SADHUKHAN LANE NEAR JORA SHIV MANDIR MANIRAMPUR BARRACKPORE, KOLKATA-700120 |
| Telephone No.: |
Mobile no: 7003958297 |
| E-mail: suman01.samanta@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: 310188183 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052086 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: SUMAN SAMANTA |
| Mother's Name: CHAMPA SAMANTA |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 02 Jan 2002 |
Nationality: INDIAN |
| Place of Birth: WEST BENGAL |
Personal Identification Mark: A MOLE IN THE RIGHT SHOULDER |
| Blood Group: O + |
Address for Communication: H.N SADHUKHAN LANE NEAR JORA SHIV MANDIR MANIRAMPUR BARRACKPORE, KOLKATA-700120 |
| State: West Bengal |
Country: India |
| Pin: 700120 |
City/District: KOLKATA |
| Mobile no: 7003958297 |
Telephone No. with STD code: |
| Aadhar Card No:758531821630 |
E-mail: suman01.samanta@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: SWARUP KUMAR SAMANTA |
Relationship with candidate: FATHER |
| Parents Date of Birth: 03 Jan 1975 |
Parent's/Guardian's Occupation/Designation: EX-ARMY |
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| Office Address: |
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| Address: ASC RECORD MT BANGALORE |
| Country: India |
State: West Bengal |
| City/District: KOLKATA |
Pin: 700120 |
| Tel: |
Mobile no.: 6289715396 |
| Fax: |
Email: swarup03.samanta@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: 2020 |
| Board: CBSE |
Board: CBSE |
| School: ARMY PUBLIC SCHOOL BARRACKPORE |
School: CENTRAL MODEL SCHOOL BARRACKPORE |
| City: KOLKATA |
City: KOLKATA |
| English %: 86 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 84 |
School/College Code: |
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Centre code: |
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Address of School/College: 23, RIVERSIDE ROAD,
BARRACKPORE KOLKATA-700120 |
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Pin: 700120 |
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Contact Nos: |
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Email: suman01.samanta@gmail.com |
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Aggregate Percentage: |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
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| Chemistry |
100 |
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| Mathematics |
100 |
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| Physics, Chemistry & Mathematics combined Percentage: |
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| English |
100 |
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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 ?: After completing my schooling class XII standard gives me a big relaxation , relax for a while and eventually to take rest and thus work upon building a career .Completing class XII aim at trying to make on many courses to make the next step of my life. |
| Why do you wish to join TMI?: i want to join this Institution because it gives me a solemn opportunity where I can implement my skills and knowledge I acquired from my education and internship. |
| What are your hobbies?: Drawing ,Painting and craft |
| What are your strengths?: My parents, supporters, honesty and Integrity |
| What are your weaknesses?: Too sensitive, Too detail oriented |
| How do you intend to meet the expenses of this program?: Bank Loan |
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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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