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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: DNS2052732 |
Name: Dennis joseph |
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Address: 3 -C-22 V. V. Colony Shaktinagar |
| Telephone No.: 7985341680 |
Mobile no: 7985341680 |
| E-mail: josephdenit@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: 312462489 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052732 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: Dennis joseph |
| Mother's Name: Shyla joseph |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 19 Sep 1999 |
Nationality: Indian |
| Place of Birth: Kerala |
Personal Identification Mark: Mole on the hip |
| Blood Group: O + |
Address for Communication: 3 -C-22 V. V. Colony Shaktinagar |
| State: Uttar Pradesh |
Country: India |
| Pin: 231222 |
City/District: Sonebhdra |
| Mobile no: 7985341680 |
Telephone No. with STD code: 7985341680 |
| Aadhar Card No:226777714421 |
E-mail: josephdenit@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Bijo joseph |
Relationship with candidate: Father |
| Parents Date of Birth: 29 Mar 1974 |
Parent's/Guardian's Occupation/Designation: Central goverment |
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| Office Address: |
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| Address: 3 -C-22 V. V. Colony Shaktinagar |
| Country: India |
State: Uttar Pradesh |
| City/District: Sonebhdra |
Pin: 231222 |
| Tel: 7985341680 |
Mobile no.: 9984904199 |
| Fax: |
Email: bijojoseph1974@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2015 |
Year of Passing: 2017 |
| Board: CBSE |
Board: CBSE |
| School: K.V.CHOPAN |
School: ST.JOSEPH SCHOOL |
| City: OBRA |
City: Shaktinagar |
| English %: 86 |
Board Roll No./Seat No.: 5709094 |
| Aggregate Percentage: 87 |
School/College Code: 71222 |
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Centre code: 7288 |
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Address of School/College: 3 -C-22
V. V. Colony |
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Pin: 231222 |
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Contact Nos: 7985341680 |
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Email: dj4943926@gmail.com |
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Aggregate Percentage: 81 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
83 |
83 |
| Chemistry |
100 |
80 |
80 |
| Mathematics |
100 |
82 |
82 |
| Physics, Chemistry & Mathematics combined Percentage: |
81.67 |
| English |
100 |
69 |
69 |
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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 |
| 08/2011 |
Basketball |
Participation at regional level |
Winner |
| 09/2012 |
Khokho |
Participation |
Participation at regional level |
| 08/2014 |
Volleyball |
Particapation at regional level at varansi |
Participation at regional level |
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| Vocational and Training Courses undertaken: |
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| MONTH / YEAR (MM/YYYY) |
COURSE |
COURSE DURATION |
| 08/2010 |
The bharat scouts and guides |
Dwitiya sopan testing camp |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: Playing volleyball and keyboard |
| Why do you wish to join TMI?: Because it is best college for DNS and I have excellence in my accademics and I intersted to join in TMI |
| What are your hobbies?: Playing volleyball and keyboard |
| What are your strengths?: Discipline and dedication |
| What are your weaknesses?: Sensitive |
| 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
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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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