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: DNS2173763 Name: Bhupendra Singh
  Address: Plot471, Lakshmipuram Shantipuram, Phaphamau, Prayagraj Opposite Punjab National Bank ATM
Telephone No.: 8736929310 Mobile no: 8736929310
E-mail: bhupendra5797.singhssa@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: 425432198
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173763 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: DNS2173763
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Bhupendra Singh
Mother's Name: Poonam Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Oct 2001 Nationality: Indian
Place of Birth: Port Blair Personal Identification Mark: Mole on left wrist
Blood Group: B + Address for Communication: Plot471, Lakshmipuram Shantipuram, Phaphamau, Prayagraj Opposite Punjab National Bank ATM
State: Uttar Pradesh Country: India
Pin: 211013 City/District: Prayagraj
Mobile no: 8736929310 Telephone No. with STD code: 8736929310
Aadhar Card No:551448879822 E-mail: bhupendra5797.singhssa@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Krishna Kumar Singh Relationship with candidate: Father
Parents Date of Birth: 15 Oct 1975 Parent's/Guardian's Occupation/Designation: Serving in Indian Navy
   
Office Address:
   
Address: Raqas, INS Utkrosh, Port Blair
Country: India State: Tamil Nadu
City/District: Port Blair Pin: 744103
Tel: Mobile no.: 8547977372
Fax: Email: krishnapriyans.singh@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Sainik School Amaravathinagar School: Sainik School Amaravathinagar
City: Coimbatore City: Tiruppur
English %: 91 Board Roll No./Seat No.: 4621162
Aggregate Percentage: 79 School/College Code: 06908
  Centre code: 06908
  Address of School/College: Amaravathinagar, Udumalpet taluk, Tiruppur district
  Pin: 642102
  Contact Nos: 04252256296
  Email: mailtosainik@gmail.com
  Aggregate Percentage: 79
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 75 75
Chemistry 100 85 85
Mathematics 100 66 66
Physics, Chemistry & Mathematics combined Percentage: 75.33
English 100 91 91
   
IMU CET Application Number: CETF21300374  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
11/2016 Aquatics school level 3rd
07/2018 Basketball school level 2nd
10/2018 Hammer throw school level 1st
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
08/2016 NCC camp 10 days
08/2016 NCC camp 10 days
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: i intend to spend it productively by improving upon my skills and applying the theory into real life practice.
Why do you wish to join TMI?: i strongly believe that TMI is a place where i can have he opportunity to learn and grow while applying the knowledge into practice
What are your hobbies?: reading novels and listening to music
What are your strengths?: harde and smart working, humble, curiosity for knowledge
What are your weaknesses?: i get a bit lethargic sometimes upon which i start working to eliminate the weakness
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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