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)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2052720 Name: Harsh Bhriguvanshi
  Address: Sanjay Kumar Singh, SIKARI, Sikari, District Chandauli
Telephone No.: Mobile no: 9450011383
E-mail: sk413135@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: 324013947
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052720 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 
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.

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

 
  Dossier ID: DNS2052720
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Harsh Bhriguvanshi
Mother's Name: Geeta Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Jul 2002 Nationality: India
Place of Birth: Chandauli Personal Identification Mark: Mole on left hand
Blood Group: B + Address for Communication: Sanjay Kumar Singh, SIKARI, Sikari, District Chandauli
State: Uttar Pradesh Country: India
Pin: 212302 City/District: Chandauli
Mobile no: 9450011383 Telephone No. with STD code:
Aadhar Card No:316772579631 E-mail: sk413135@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sanjay Kumar Singh Relationship with candidate: Father
Parents Date of Birth: 06 Jul 1965 Parent's/Guardian's Occupation/Designation: Farmer
   
Office Address:
   
Address: Sanjay Kumar Singh, SIKARI, Sikari, District Chandauli
Country: India State: Uttar Pradesh
City/District: Chandauli Pin: 232102
Tel: Mobile no.: 8840595391
Fax: Email: sk413135@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Udai Pratap Public School School: Udai pratap public school
City: Varanasi City: Varanasi
English %: 76 Board Roll No./Seat No.: 5754873
Aggregate Percentage: 72 School/College Code: 09156
  Centre code: 5363
  Address of School/College: Bhojubir, Varanasi
  Pin: 221002
  Contact Nos: 8004932850
  Email: upps_vns2009@rediffmail.com
  Aggregate Percentage: 76
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 63 63
Chemistry 100 76 76
Mathematics 100 75 75
Physics, Chemistry & Mathematics combined Percentage: 71.33
English 100 74 74
   
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
11/2017 Running School level None
11/2018 Basketball School level None
11/2018 Basketball School level None
11/2019 Basketball School level None
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Studies, playing Basketball, etc.
Why do you wish to join TMI?: This time TMI give best Maritime training and placement and best campus.
What are your hobbies?: Sketching, playing Basketball, photoshop.
What are your strengths?: I Easily adopt the condition and the climate quickly,easily mingle with other, always in discipline, do work on time
What are your weaknesses?: Talkative by nature.
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate Class XII admit card Class XII marksheet
 
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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