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: DNS2173269 Name: Mohammed Imran
  Address: Ward No 25 Village Lakhanchand PO Mokamaghat Mokama
Telephone No.: Mobile no: 7281070355
E-mail: mdimranmka1@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: 425172477
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173269 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: DNS2173269
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohammed Imran
Mother's Name: Mohabiya Khatoon
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Aug 2003 Nationality: Indian
Place of Birth: Mokama Personal Identification Mark: Cut Mark on Head
Blood Group: B + Address for Communication: Ward No 25 Village Lakhanchand PO Mokamaghat Mokama
State: Bihar Country: India
Pin: 803303 City/District: Mokama
Mobile no: 7281070355 Telephone No. with STD code:
Aadhar Card No:900366509216 E-mail: mdimranmka1@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: MD Rizwan Relationship with candidate: Father
Parents Date of Birth: 28 Sep 1973 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: Ward No 25 Village Lakhanchand PO Mokamaghat
Country: India State: Bihar
City/District: Patna Pin: 803303
Tel: Mobile no.: 9934364624
Fax: Email: rizwanindia8076@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: ST MARYS ENGLISH SCHOOL BARBIGHA School: DUN GLOBAL PUBLIC SCHOOL PATNA
City: SEIKHPURA City: PATNA
English %: 61 Board Roll No./Seat No.:
Aggregate Percentage: 62 School/College Code:
  Centre code:
  Address of School/College: PATNA
  Pin: 800001
  Contact Nos:
  Email: mdimranmka1@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:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Self Study
Why do you wish to join TMI?: Because I like Shipping Company Job
What are your hobbies?: Reading Book, Jim and playing Cricket
What are your strengths?: Adjust in all atmosphere
What are your weaknesses?: shy
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 not uploaded
 
Declaration

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

Signature of Candidate

 

___________________

Date ________________

 
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