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: DNS2173084 Name: Pawan Kumar Rai
  Address: C-5/13 , sector-3, cbd belapur, Navi Mumbai B-10/6 , sector-4 , cbd belapur, Navi Mumbai
Telephone No.: 08169599525 Mobile no: 8169599525
E-mail: pawanrai6616@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425081442
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173084 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: DNS2173084
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Pawan Kumar Rai
Mother's Name: Madhu Vinod Rai
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 25 Jan 2003 Nationality: Indian
Place of Birth: CBD Belapur Personal Identification Mark: Left palm
Blood Group: B + Address for Communication: C-5/13 , sector-3, cbd belapur, Navi Mumbai B-10/6 , sector-4 , cbd belapur, Navi Mumbai
State: Maharashtra Country: India
Pin: 400614 City/District: Navi Mumbai
Mobile no: 8169599525 Telephone No. with STD code: 08169599525
Aadhar Card No:816164308483 E-mail: pawanrai6616@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Vinod Kumar Rai Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1978 Parent's/Guardian's Occupation/Designation: Buisness
   
Office Address:
   
Address: Sector - 4 , CBD Belapur Sector - 4, CBD Belapur
Country: India State: Maharashtra
City/District: Navi Mumbai Pin: 400614
Tel: 08169599525 Mobile no.: 9082887239
Fax: Email: raiv.7890@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Bharati Vidyapeeth school School: Bharati Vidyapeeth college
City: Navi Mumbai City: Navi Mumbai
English %: 76 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code:
  Centre code:
  Address of School/College: Sector-3 , CBD Belapur, Navi Mumbai
  Pin: 400614
  Contact Nos:
  Email: pawanrai6616@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
2019 2018 2019 2018
Football Football Athletics Athletics
District sports organization District sports organization District sports organization District sports organization
Defence Defence Selected in final Select in semifinals
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: By doing
Why do you wish to join TMI?: Because tmi is a good college for the study for merchant navy. It will help me in joining merchant navy
What are your hobbies?: Football, trekking, cycling
What are your strengths?: Communication, Self control, discipline, trust worthiness, patients
What are your weaknesses?: Fear of loosing anyone
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 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

 

___________________

Date ________________

 
Print Summary and Application Form