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: DNS2173415 Name: YADAV SURAJ AVINASH URMILA
  Address: No.1 KOMAL NIWAS CHAWL FARID NAGAR , PN ROAD BHANDUP WEST
Telephone No.: Mobile no: 9892977429
E-mail: surajayadav74@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425450681
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173415 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: DNS2173415
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: YADAV SURAJ AVINASH URMILA
Mother's Name: URMILA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 03 May 2004 Nationality: INDIAN
Place of Birth: AZAMGARH Personal Identification Mark: None
Blood Group: B + Address for Communication: No.1 KOMAL NIWAS CHAWL FARID NAGAR , PN ROAD BHANDUP WEST
State: Maharashtra Country: India
Pin: 400078 City/District: MUMBAI SUBURBAN
Mobile no: 9892977429 Telephone No. with STD code:
Aadhar Card No:309518103811 E-mail: surajayadav74@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: AVINASH Relationship with candidate: FATHER
Parents Date of Birth: 10 Apr 1980 Parent's/Guardian's Occupation/Designation: SERVICE
   
Office Address:
   
Address: CEAT LTD, VILLAGE ROAD, BHANDUP WEST, MUMBAI-400078
Country: India State: Maharashtra
City/District: MUMBAI SUBURBAN Pin: 400078
Tel: Mobile no.: 8850537937
Fax: Email: ay90967558@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: B.P.E.S HIGH SCHOOL School: NES RATNAM JUNIOR COLLEGE
City: MUMBAI City: MUMBAI
English %: 56 Board Roll No./Seat No.:
Aggregate Percentage: 79 School/College Code:
  Centre code:
  Address of School/College: National High School Marg, NES Road, Bhandup, Battipada, Bhandup West, Mumbai, Maharashtra 400078
  Pin: 400078
  Contact Nos: 022259513381
  Email: ratnam_college@rediffmail.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
12/2020 Kabaddi College 1st
12/2019 Discuss throw College 3rd
12/2018 Standing broad jump School 1st
12/2016 Kabaddi School 2nd
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Spending time with family and interacting with them reading some books collecting information of current situations. Excited for doing new thing.
Why do you wish to join TMI?: Obviously a very great college to start a carrier as merchant navy and a very high chance of getting sponsored by a great institute.
What are your hobbies?: Cricket, kabbadi
What are your strengths?: 4.like to learn new things,always have a very positive attitude,like new challenges
What are your weaknesses?: Easily believe everyone
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate 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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