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 2021)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2170896 Name: Ayaz Khan
  Address: 161 DHARAMPUR Dehradun
Telephone No.: 07253951236 Mobile no: 7253951236
E-mail: ayaazkhan0987@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 422622309
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2170896 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 - 2021

 
  Dossier ID: DNS2170896
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Ayaz Khan
Mother's Name: Keshar Jaha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 16 Nov 2002 Nationality: Indian
Place of Birth: Dehradun Personal Identification Mark: Two small black spot below right eye
Blood Group: B + Address for Communication: 161 DHARAMPUR Dehradun
State: Uttaranchal Country: India
Pin: 248001 City/District: DEHRADUN
Mobile no: 7253951236 Telephone No. with STD code: 07253951236
Aadhar Card No:666934821497 E-mail: ayaazkhan0987@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Riyaj Khan Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1977 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: 161 DHARAMPUR Dehradun
Country: India State: Uttaranchal
City/District: Dehradun Pin: 248001
Tel: 08126926522 Mobile no.: 7253951236
Fax: Email: ayaazkhan0987@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Shri Guru Ram Rai Public School School: Shri Guru Ram Rai Public School
City: DEHRADUN City: Dehradun
English %: 88 Board Roll No./Seat No.: 25609423
Aggregate Percentage: 78 School/College Code: 81073
  Centre code: 8041
  Address of School/College: Amarshahid Anand Colony, Race Course, Dehradun, Uttarakhand 248001
  Pin: 248001
  Contact Nos:
  Email: sgrrits@nde.vsnl.net.in
  Aggregate Percentage: 81
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 69 69
Chemistry 100 68 68
Mathematics 100 63 63
Physics, Chemistry & Mathematics combined Percentage: 66.67
English 100 88 88
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I had work on my weaknesses and studied for IMUCET exam
Why do you wish to join TMI?: I like to start my career in with trustable college and company.TMI is one of the best college and provide best facilities and training to their students
What are your hobbies?: I am very fond of exploring off-beats places and meeting new people.Also i like to play football because it reguvinates me and a passion for music
What are your strengths?: I am very positive and i find easy to talk to strangers moreover i am emphatical and incusitive by nature as i always keen to learn more knowledge.
What are your weaknesses?: The only weakness i am left with is my communication skills is not that much good but i trying my best to improve it.
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 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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