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: DNS2170908 Name: ANIKET KUMAR SRIVASTAVA
  Address: MISSIONPARA,,PANCHUDANGA PO.-ADRA DIST.-PURULIA,WEST BENGAL
Telephone No.: Mobile no: 8967988593
E-mail: aniketsrivastava4519@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 422850493
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2170908 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: DNS2170908
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: ANIKET KUMAR SRIVASTAVA
Mother's Name: PREMLATA SRIVASTAVA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 26 Dec 2002 Nationality: INDIAN
Place of Birth: WEST BENGAL Personal Identification Mark: A MOLE ON THE LEFT HAND PALM
Blood Group: O + Address for Communication: MISSIONPARA,,PANCHUDANGA PO.-ADRA DIST.-PURULIA,WEST BENGAL
State: West Bengal Country: India
Pin: 723121 City/District: PURULIA
Mobile no: 8967988593 Telephone No. with STD code:
Aadhar Card No:796011462903 E-mail: aniketsrivastava4519@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: MANOJ KUMAR SRIVASTAVA Relationship with candidate: FATHER
Parents Date of Birth: 13 Jan 1973 Parent's/Guardian's Occupation/Designation: RAILWAY EMPLOYEE
   
Office Address:
   
Address: S.S.E SIGNAL NO 2 PO.-ADRA DIST.-PURULIA,WEST BENGAL
Country: India State: West Bengal
City/District: PURULIA Pin: 723121
Tel: Mobile no.: 8967988593
Fax: Email: manojsrivastavaadra@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: KENDRIYA VIDYALAYA ADRA School: KENDRIYA VIDYALAYA ADRA
City: ADRA City: ADRA
English %: 78 Board Roll No./Seat No.: 12646846
Aggregate Percentage: 69 School/College Code: 19201
  Centre code: 1793
  Address of School/College: PO.-ADRA, DIST.-PURULIA
  Pin: 723121
  Contact Nos: 03251244232
  Email: kvadraprincipal@gmail.com
  Aggregate Percentage: 79
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 66 66
Chemistry 100 88 88
Mathematics 100 65 65
Physics, Chemistry & Mathematics combined Percentage: 73
English 100 93 93
   
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
08/2017 KHO KHO REGIONAL 2nd
09/2016 FOOTBALL INTERSCHOOL 1st
09/2018 KABADDI REGIONAL 2nd
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
04/2014 COMPUTER BASICS 1 Year 6 Months
06/2016 COMPUTER PROGRAMMING 2 Years
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: TO ENHANCE MY VOCABULARY SKILLS AND LEARN DIFFERENT LANGUAGES AND GENERAL KNOWLEDGE.
Why do you wish to join TMI?: IT WILL PROVIDE ME A GREAT PLATFORM TO ACHIEVE MY GOALS IN THIS FIELD.
What are your hobbies?: READING BOOKS AND DICTIONARIES,SINGING AND WRITING QUOTES
What are your strengths?: BROADMINDED,FOCUSED TOWARDS MY GOALS AND QUITE STRAIGHT FORWARD TOWARDS IT.
What are your weaknesses?: BEING TOO HONEST
How do you intend to meet the expenses of this program?: 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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