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: DNS2171210 Name: Bipin K P
  Address: Kotigowdana mane Yenekal ,kadaba , dakshina kannada Manglore
Telephone No.: 09148729805 Mobile no: 9148729805
E-mail: bipinkp007@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 428648817
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2171210 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: DNS2171210
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Bipin K P
Mother's Name: Renuka k
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Jan 2002 Nationality: India
Place of Birth: Puttur Personal Identification Mark: Mole on neck
Blood Group: O + Address for Communication: Kotigowdana mane Yenekal ,kadaba , dakshina kannada Manglore
State: Karnataka Country: India
Pin: 574238 City/District: Mangalore
Mobile no: 9148729805 Telephone No. with STD code: 09148729805
Aadhar Card No:997262016112 E-mail: bipinkp007@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Purushothama k Relationship with candidate: Father
Parents Date of Birth: 28 Feb 1966 Parent's/Guardian's Occupation/Designation: Nill
   
Office Address:
   
Address: Kotigowdana mane Yenekal Post ,kadaba Dakshina kannada
Country: India State: Karnataka
City/District: Manglore Pin: 574238
Tel: 8217362394 Mobile no.: 9148729805
Fax: Email: bipinkoti007@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Jawahar navodaya Vidyalaya School: Jawahar navodaya Vidyalaya
City: Mangalore City: Manglore
English %: 86 Board Roll No./Seat No.: 18610245
Aggregate Percentage: 79 School/College Code: 06450
  Centre code: 4281
  Address of School/College: Jawahar navodaya Vidyalaya,Mudipu Kurnad post ,bantwal D.K dust.
  Pin: 574153
  Contact Nos:
  Email: jnvmangalore@gmail.com
  Aggregate Percentage: 83
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 87 87
Chemistry 100 75 75
Mathematics 100 85 85
Physics, Chemistry & Mathematics combined Percentage: 82.33
English 100 87 87
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Reading, surfing in net, playing,Gardening
Why do you wish to join TMI?: Top collage, best facilities, infrastructure
What are your hobbies?: Reading, playing, coin collection, gardening, shading
What are your strengths?: Creativity, enthusiasm of learning, honesty, leadership, open minded, strong work ethic
What are your weaknesses?: Trouble in saying NO
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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