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: DNS2171993 Name: PUSHPAK KIRANKUMAR PANDORE
  Address: ARADHANA SOC RH 80 FLAT NO.10 G BLOCK SHAHUNAGAR CHINCHWAD,PIMPRI CHINCHWAD PIN 411019 , MAHARASHTRA, INDIA
Telephone No.: - Mobile no: 8767344736
E-mail: pkpandore888@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: 424628057
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2171993 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________

   
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: DNS2171993
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PUSHPAK KIRANKUMAR PANDORE
Mother's Name: SEEMA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 29 Nov 2002 Nationality: INDIA
Place of Birth: PUNE Personal Identification Mark: Mole on left fore head
Blood Group: O + Address for Communication: ARADHANA SOC RH 80 FLAT NO.10 G BLOCK SHAHUNAGAR CHINCHWAD,PIMPRI CHINCHWAD PIN 411019 , MAHARASHTRA, INDIA
State: Maharashtra Country: India
Pin: 411019 City/District: PUNE
Mobile no: 8767344736 Telephone No. with STD code: -
Aadhar Card No:455387524234 E-mail: pkpandore888@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: KIRANKUMAR Relationship with candidate: FATHER
Parents Date of Birth: 07 Aug 1975 Parent's/Guardian's Occupation/Designation: Service
   
Office Address:
   
Address: ARADHANA SOC RH 80 FLAT NO.10 G BLOCK SHAHUNAGAR CHINCHWAD,PIMPRI CHINCHWAD PIN 411019 , MAHARASHTRA, INDIA
Country: India State: Maharashtra
City/District: PUNE Pin: 411019
Tel: Mobile no.: 8767344736
Fax: Email: pkpandore888@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Maharashtra
School: SNBP INTERNATIONAL SCHOOL School: Bapuji sahadu kadu patil junior collage
City: PUNE City: satral
English %: 54 Board Roll No./Seat No.:
Aggregate Percentage: 61 School/College Code:
  Centre code:
  Address of School/College: At-Satral, post-songaon,Tal- Rahuri, Dist- Ahmednagar
  Pin: 413711
  Contact Nos: 08767344736
  Email: pkpandore888@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
04/2019 kabbadi District 1
05/2021 Kabbadi State level 4
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Nice
Why do you wish to join TMI?: It is one of the most reputeted college for merchant navy
What are your hobbies?: Playing
What are your strengths?: Good communication skills
What are your weaknesses?: Tendency to take on too much responsibility
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 not uploaded Class X marksheet School leaving certificate 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

 

___________________

Date ________________

 
Print Summary and Application Form