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: DNS2052809 Name: RAKESH MAHESH NIKAM
  Address: SUDARSHAN plotno19 laxminagar ganeshpur main road 8th cross belgaum
Telephone No.: 08312446377 Mobile no: 7022999201
E-mail: captainrmn1604@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 312681064
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052809 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: DNS2052809
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: RAKESH MAHESH NIKAM
Mother's Name: SAROJA NIKAM
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 16 Apr 2001 Nationality: INDIAN
Place of Birth: KARNATAKA Personal Identification Mark: MOLE ON LEFT THIGH
Blood Group: A - Address for Communication: SUDARSHAN plotno19 laxminagar ganeshpur main road 8th cross belgaum
State: Karnataka Country: India
Pin: 590001 City/District: belgaum
Mobile no: 7022999201 Telephone No. with STD code: 08312446377
Aadhar Card No:741975224533 E-mail: captainrmn1604@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: MAHESH NIKAM Relationship with candidate: FATHER
Parents Date of Birth: 05 Sep 1965 Parent's/Guardian's Occupation/Designation: BUSINESS MAN
   
Office Address:
   
Address: SUDARSHAN zenda chowk belgaum city Karnataka
Country: India State: Karnataka
City/District: belgaum Pin: 561108
Tel: 08312446377 Mobile no.: 9980384025
Fax: Email: poo.nikam97@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2020
Board: Karnataka Board: Karnataka
School: ST.PAUL HIGH SCHOOL BELGAUM School: RAJA LAKHAMGOAUDA PRE UNIVERSITY SCIENCE COLLEGE BELGAUM
City: BELGAUM City: BELGAUM
English %: 83 Board Roll No./Seat No.:
Aggregate Percentage: 73 School/College Code:
  Centre code:
  Address of School/College: college road belgaum 590001
  Pin: 590001
  Contact Nos:
  Email: rlscibgm@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
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
11/2018 NCC IGC CDT
04/2016 NCC A CDT
05/2019 NCC B CDT
06/2018 NCC CATC CDT
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Continue being fit by indulging in playing cricket and increasing my knowledge on TMI
Why do you wish to join TMI?: - Enhancing Professionalism - High discipline - Possess good communication skill and extreme resourcefulness
What are your hobbies?: Playing Cricket
What are your strengths?: Punctual, Team spirit
What are your weaknesses?: Helping nature, Workoholic.
How do you intend to meet the expenses of this program?: Own Resources
 
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 not uploaded
 
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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