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: DNS2173205 Name: Shaikh Shehzad Jakauddin
  Address: MHB Colony, 34/271, Gate no-7,Gaikwad Nagar, Malwani, Malad West, Mumbai-95
Telephone No.: Mobile no: 9833162393
E-mail: mirzashaikh452@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 432829093
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173205 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: DNS2173205
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Shaikh Shehzad Jakauddin
Mother's Name: Kaniz Fatima
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 May 2003 Nationality: India
Place of Birth: Mumbai Personal Identification Mark: Mole on right hand
Blood Group: A + Address for Communication: MHB Colony, 34/271, Gate no-7,Gaikwad Nagar, Malwani, Malad West, Mumbai-95
State: Maharashtra Country: India
Pin: 400095 City/District: Mumbai
Mobile no: 9833162393 Telephone No. with STD code:
Aadhar Card No: E-mail: mirzashaikh452@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Shaikh Jakauddin Relationship with candidate: Father
Parents Date of Birth: 14 Aug 1967 Parent's/Guardian's Occupation/Designation: Cab Driver
   
Office Address:
   
Address: MHB Colony, 34/271, Gate no-7, Gaikwad Nagar, Malwani, Malad West, Mumbai- 95
Country: India State: Maharashtra
City/District: Mumbai Pin: 400095
Tel: Mobile no.: 9833292162
Fax: Email: mirzashaikh452@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: Secondary School School: R D National College
City: Mumbai City: Mumbai
English %: 72 Board Roll No./Seat No.:
Aggregate Percentage: 81 School/College Code:
  Centre code:
  Address of School/College: Linking road, Bandra West, Mumbai 400050
  Pin: 400050
  Contact Nos:
  Email: rdnational@vsnl.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
03/2013 Drawing School 2nd
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Taking a big relaxation for a while and then eventually working on my career goals
Why do you wish to join TMI?: Best Maritime academy in India with the maximum training and knowledge
What are your hobbies?: Travelling and Reading
What are your strengths?: Discipline, trustworthy and respectfulness
What are your weaknesses?: Nervousness about public speaking and being too honest
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

 

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Date ________________

 
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