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: DNS2173134 Name: Kushlesh Dubey
  Address: Tilwari Badalapur Jaunpur Jaunpur Uttar Pradesh Khuthan Shahganj Uttar Pradesh
Telephone No.: 6306437522 Mobile no: 6306437522
E-mail: kushd9628@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 434995567
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173134 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: DNS2173134
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Kushlesh Dubey
Mother's Name: Neelam Dubey
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Nov 2002 Nationality: Indian
Place of Birth: Jaunpur UP Personal Identification Mark: A cut mark on left hand thumb
Blood Group: O + Address for Communication: Tilwari Badalapur Jaunpur Jaunpur Uttar Pradesh Khuthan Shahganj Uttar Pradesh
State: Uttar Pradesh Country: India
Pin: 223107 City/District: Jaunpur
Mobile no: 6306437522 Telephone No. with STD code: 6306437522
Aadhar Card No:804215772869 E-mail: kushd9628@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Neelam Dubey Relationship with candidate: My mother
Parents Date of Birth: 10 May 1985 Parent's/Guardian's Occupation/Designation: Housewife
   
Office Address:
   
Address: Tilwari Badalapur Jaunpur Jaunpur Uttar Pradesh Khuthan Shahganj Uttar Pradesh
Country: India State: Uttar Pradesh
City/District: Jaunpur Pin: 223107
Tel: 6306437522 Mobile no.: 9129065753
Fax: Email: dubeyneelam1051985@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Uttar Pradesh Board: Uttar Pradesh
School: Maa Sharda Inter College Tiyara Badlapur Jaunpur Uttar Pradesh School: Gram Vikas Inter College Khutahan Jaunpur Uttar Pradesh
City: Jaunpur City: Jaunpur
English %: 90 Board Roll No./Seat No.: 1877487
Aggregate Percentage: 82 School/College Code: 1081
  Centre code: 07379
  Address of School/College: Khutahan Jaunpur Uttar Pradesh
  Pin: 223104
  Contact Nos:
  Email: support@studyapt.com
  Aggregate Percentage: 72
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 67 67
Chemistry 100 81 81
Mathematics 100 64 64
Physics, Chemistry & Mathematics combined Percentage: 70.67
English 100 75 75
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I was working hard for imu cet and sponsorship test
Why do you wish to join TMI?: It is the largest maritime institute of Asia.
What are your hobbies?: My hobbies are reading books such as story books ,historical books
What are your strengths?: My strength is my stability and panctuality
What are your weaknesses?: I can not see injustice happening to someone and try to solve it
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
 
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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