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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: DNS2052152 |
Name: Allmin raza shamshad anjum |
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Address: T5/1mandaly line Behind shiv mandir military hospital kirkee Kirkee pune |
| Telephone No.: |
Mobile no: 7030862310 |
| E-mail: allmin14198@gmail.com |
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| Application fee payment details: |
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| Payment Status: failure |
Payment Mode: Online |
| Amount: ₹ 200 |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 310334162 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052152 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: Allmin raza shamshad anjum |
| Mother's Name: Anjum ara |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 14 Sep 2002 |
Nationality: Indian |
| Place of Birth: Bihar |
Personal Identification Mark: Mole on face |
| Blood Group: B + |
Address for Communication: T5/1mandaly line Behind shiv mandir military hospital kirkee Kirkee pune |
| State: Maharashtra |
Country: India |
| Pin: 411020 |
City/District: Pune |
| Mobile no: 7030862310 |
Telephone No. with STD code: |
| Aadhar Card No: |
E-mail: allmin14198@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Shamshad alan ansary |
Relationship with candidate: Father and son |
| Parents Date of Birth: 11 Nov 1969 |
Parent's/Guardian's Occupation/Designation: Government services |
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| Office Address: |
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| Address: Military hospital kirkee Kirkee pune |
| Country: India |
State: Maharashtra |
| City/District: Pune |
Pin: 411020 |
| Tel: |
Mobile no.: 7030862309 |
| Fax: |
Email: allmin78692@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: CBSE |
Board: CBSE |
| School: Army public school kirkee |
School: Army public school kirkee |
| City: Pune |
City: Pune |
| English %: 85 |
Board Roll No./Seat No.: |
| Aggregate Percentage: 82 |
School/College Code: |
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Centre code: |
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Address of School/College: Army public school kirkee BEG CENTER PUNE |
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Pin: 411003 |
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Contact Nos: |
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Email: apskirkee11@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 ?: Studing for various exam |
| Why do you wish to join TMI?: Best institute for me |
| What are your hobbies?: Playing cricket |
| What are your strengths?: My father |
| What are your weaknesses?: Food |
| 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 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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