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: DNS2173106 Name: Mohammadkaif Shabuddin Herwade
  Address: Devendra society 100ft road Sangli
Telephone No.: 07066392786 Mobile no: 7066392786
E-mail: mkaif14herwade@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: 425867291
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173106 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: DNS2173106
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohammadkaif Shabuddin Herwade
Mother's Name: Rahila
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Nov 2002 Nationality: Indian
Place of Birth: Sangli Personal Identification Mark: Black spot on left abdomen
Blood Group: A + Address for Communication: Devendra society 100ft road Sangli
State: Maharashtra Country: India
Pin: 416416 City/District: Sangli
Mobile no: 7066392786 Telephone No. with STD code: 07066392786
Aadhar Card No:391762828555 E-mail: mkaif14herwade@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Shabuddin Herwade Relationship with candidate: Father
Parents Date of Birth: 27 Jan 1981 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: Devendra society 100ft road Sangli
Country: India State: Maharashtra
City/District: Sangli Pin: 416416
Tel: 09975991999 Mobile no.: 7066392786
Fax: Email: mkaif14herwade@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: Maharashtra
School: Santhome School Sangli School: Vidhya Mandir prashala Miraj
City: Sangli City: Sangli
English %: 84 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code:
  Centre code:
  Address of School/College: Bhramanpur nagar
  Pin: 416410
  Contact Nos:
  Email: mkaif14herwade@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
04/2021 Athletics Talku and districts level 1st in relay and 2nd in 200m
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I would work more on fitness
Why do you wish to join TMI?: Gives more opportunities
What are your hobbies?: Sports ,listening songs
What are your strengths?: Workholic and fitness
What are your weaknesses?: A bit anger
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