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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: DNS2052113 |
Name: Rajdeep Mahto |
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Address: Vill-manatu P.S-kanke,P.O-kamre Ranchi 835222 |
Telephone No.: |
Mobile no: 6203624189 |
E-mail: bipinkumar1122@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: 310213144 |
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Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052113 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: Rajdeep Mahto |
Mother's Name: Asha Devi |
Gender (M/F): Male |
Marital Status (Single/Married): Single |
Date of Birth (DD/MM/YY): 04 Dec 2002 |
Nationality: Indian |
Place of Birth: RANCHI |
Personal Identification Mark: MOLE MARK ON NECK |
Blood Group: A + |
Address for Communication: Vill-manatu P.S-kanke,P.O-kamre Ranchi 835222 |
State: Jharkhand |
Country: India |
Pin: 835222 |
City/District: Ranchi |
Mobile no: 6203624189 |
Telephone No. with STD code: |
Aadhar Card No: |
E-mail: bipinkumar1122@gmail.com |
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Guardian's Particulars: |
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Name of Parent/Guardian: Mahendra Mahto |
Relationship with candidate: Father |
Parents Date of Birth: 18 Oct 1967 |
Parent's/Guardian's Occupation/Designation: Agriculture |
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Office Address: |
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Address: Vill-manatu P.S-kanke,P.O-kamre Ranchi |
Country: India |
State: Jharkhand |
City/District: Ranchi |
Pin: 835222 |
Tel: |
Mobile no.: 9304061200 |
Fax: |
Email: bk7254527@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: ISCE |
Board: CBSE |
School: St Francis School |
School: Nirja sahay dav public school |
City: Ranchi |
City: Ranchi |
English %: 72 |
Board Roll No./Seat No.: |
Aggregate Percentage: 83 |
School/College Code: |
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Centre code: |
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Address of School/College: Goshala complex,kanke, jharkhand |
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Pin: 834006 |
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Contact Nos: |
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Email: nskanke@yahoo.co.in |
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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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Sports & Extra Curricular Activities: |
Achievements in Sports and Extra Curricular Activities |
MONTH / YEAR (MM/YYYY) |
SPORT/ACTIVITY |
LEVEL OF PARTICIPATION |
POSITION |
12/2016 |
Cricket |
Inter school tournament |
Winner |
12/2015 |
Cricket |
Inter school tournament |
Runner |
01/2019 |
TechnoZeal Exploring young minds |
Inter school |
Runner |
11/2013 |
Fevicol science project Challenge |
Inter school |
Runner |
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How do you intend spending your time after completing class XII Final exams and before joining college ?: Learn sports like badminton ,swimming etc. |
Why do you wish to join TMI?: It will provide best learning opportunities |
What are your hobbies?: Listening music, spending time with siblings |
What are your strengths?: Strong will power, courageous and can work for long flexy hours |
What are your weaknesses?: No weakness |
How do you intend to meet the expenses of this program?: Own Resources |
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Review you documents: |
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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