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: DNS2171185 Name: Devraj Negi
  Address: Ward no.5,VILLAGE SHYAMPUR SHYAMPUR Rishikesh
Telephone No.: 7579148253 Mobile no: 7579148253
E-mail: devilbawa13@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 422732092
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2171185 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: DNS2171185
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Devraj Negi
Mother's Name: Priti Negi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 13 Nov 2003 Nationality: Indian
Place of Birth: Rishikesh Personal Identification Mark: Left elbow injury mark
Blood Group: A + Address for Communication: Ward no.5,VILLAGE SHYAMPUR SHYAMPUR Rishikesh
State: Uttaranchal Country: India
Pin: 249204 City/District: DEHRADUN
Mobile no: 7579148253 Telephone No. with STD code: 7579148253
Aadhar Card No:666261350993 E-mail: devilbawa13@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Nirmal Singh Relationship with candidate: Father
Parents Date of Birth: 20 Dec 1976 Parent's/Guardian's Occupation/Designation: Government Servant
   
Office Address:
   
Address: PWD office ,Sector 9D Baurari New Tehri
Country: India State: Uttaranchal
City/District: Tehri Garhwal Pin: 249001
Tel: Mobile no.: 9897212424
Fax: Email: neginirmalsingh1234@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: New Tehri International School School: New Tehri International School
City: Tehri City: Tehri
English %: 79 Board Roll No./Seat No.:
Aggregate Percentage: 88 School/College Code:
  Centre code:
  Address of School/College: Village Painulla, Tehri
  Pin: 249001
  Contact Nos:
  Email: praveenbhatt2800@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
10/2018 GK Quiz Inter House 1
02/2018 Hindustan Olympiad State Level State Topper
03/2021 Hindustan Olympiad State Leve District Topper
12/2019 Handball Boys Senior Inter House 1
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Reading mythological books Visiting New Places
Why do you wish to join TMI?: Because it is a well known institute And No.1 in placement
What are your hobbies?: Playing Cricket and Badminton, reading current affairs and intresting facts
What are your strengths?: Physically strong ,mentally strong
What are your weaknesses?: Socially weak , as I take some time to interact with new people
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 not uploaded Class XII admit card not uploaded 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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