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: DNS2172367 Name: Mohammed Taheed luqman
  Address: 24-27-13 vizag one town old post office Vishakapatnam Daragae
Telephone No.: 8919132611 Mobile no: 8919132611
E-mail: taheed369@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 434519793
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2172367 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: DNS2172367
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohammed Taheed luqman
Mother's Name: Mohammed Aisha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Mar 2004 Nationality: Indian
Place of Birth: Vishakapatn Personal Identification Mark: Spot on a but
Blood Group: B + Address for Communication: 24-27-13 vizag one town old post office Vishakapatnam Daragae
State: Andhra Pradesh Country: India
Pin: 530001 City/District: Vishakapatnam
Mobile no: 8919132611 Telephone No. with STD code: 8919132611
Aadhar Card No:432551426588 E-mail: taheed369@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Mohammed Luqman Relationship with candidate: Father
Parents Date of Birth: 02 Apr 1970 Parent's/Guardian's Occupation/Designation: Vizag
   
Office Address:
   
Address: 24-27-13 one town old poat office vizag 24-27-13 Vishakapatnam daragaroad
Country: India State: Andhra Pradesh
City/District: Vizag Pin: 530001
Tel: 8919132611 Mobile no.: 8919132611
Fax: 0891 Email: taheed369@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Andhra Pradesh Board: Andhra Pradesh
School: Sri Prakash vidyanikatan School: Bvk clg
City: Vizag City: Vizag
English %: 75 Board Roll No./Seat No.: 833
Aggregate Percentage: 75 School/College Code: 530016
  Centre code: 22879
  Address of School/College: 24-27-13 one town old post office daragaroad
  Pin: 530001
  Contact Nos: 8919132611
  Email: taheed369@gmail.com
  Aggregate Percentage: 75
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 150 73 48.67
Chemistry 150 80 53.33
Mathematics 300 236 78.67
Physics, Chemistry & Mathematics combined Percentage: 60.22
English 100 75 75
   
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 Taikondo and basketballl Interschool and state Caption
04/2016 Swiming Normal For Physical fitness
07/2017 Drawing State level Student
10/2017 Clay crafting and spray painting Inter school Student
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
04/2016 Computer 2weeks
03/2019 Gyming 1year
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for imucet and gyming
Why do you wish to join TMI?: Its a dream clg for me
What are your hobbies?: Travelling
What are your strengths?: Leadership, selfconfidence
What are your weaknesses?: Patience
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
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

___________________

Date ________________

 
Print Summary and Application Form