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: DNS2173514 Name: Aashish Mishra
  Address: A-14, jindal labour colony New model Town, hisar, haryana
Telephone No.: 01662 Mobile no: 9896826857
E-mail: ayushmishra642001@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425278532
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173514 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: DNS2173514
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Aashish Mishra
Mother's Name: Veena Mishra
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Apr 2003 Nationality: INDIAN
Place of Birth: Hisar Personal Identification Mark: White mark on right leg
Blood Group: A + Address for Communication: A-14, jindal labour colony New model Town, hisar, haryana
State: Haryana Country: India
Pin: 125001 City/District: Hisar
Mobile no: 9896826857 Telephone No. with STD code: 01662
Aadhar Card No: E-mail: ayushmishra642001@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sunil Mishra Relationship with candidate: Father
Parents Date of Birth: 27 Jun 1977 Parent's/Guardian's Occupation/Designation: Service
   
Office Address:
   
Address: House no. A-14, jindal labour colony, new model town, hisar
Country: India State: Haryana
City/District: Hisar Pin: 125001
Tel: Mobile no.: 8199982945
Fax: Email: aashishmishra1104@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Haryana Board: CBSE
School: Swami servanand memorial high school School: Vishvas senior secondary school
City: Hisar City: Hisar
English %: 75 Board Roll No./Seat No.:
Aggregate Percentage: 84 School/College Code:
  Centre code:
  Address of School/College: Urban State 2, Urban Estate II, Hisar, Haryana 12500
  Pin: 125001
  Contact Nos:
  Email: aashishmishra1104@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 ?: Exploring the world in books
Why do you wish to join TMI?: For my will to explore world
What are your hobbies?: Playing kabaddi, reading about world
What are your strengths?: Good learner, eager to travel
What are your weaknesses?: Sometimes I overthink
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 ________________

 
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