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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Irshad Alam
Mother's Name: Sabrun Nesa
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 Aug 2002 Nationality: Indian
Place of Birth: Kolkata Personal Identification Mark: Aadhar card
Blood Group: B + Address for Communication: 36/14 Hara chand Mukherjee lane Howrah 1 36/14 Hara chand Mukherjee lane Howrah 1 36/14 Hara chand Mukherjee lane Howrah 1
State: West Bengal Country: India
Pin: 711101 City/District: Howrah
Mobile no: 8902147015 Telephone No. with STD code: 08902147015
Aadhar Card No:409889344767 E-mail: irshadalamtillu72@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Md Taslim Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1961 Parent's/Guardian's Occupation/Designation: Businessman
   
Office Address:
   
Address: 36/14 Hara chand Mukherjee lane Howrah 1 36/14 Hara chand Mukherjee lane Howrah 1 36/14 Hara chand Mukherjee lane Howrah 1
Country: India State: West Bengal
City/District: Howrah Pin: 711101
Tel: 08902147015 Mobile no.: 8902147015
Fax: Email: irshadalamtillu72@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: West Bengal Board: West Bengal
School: St Anns English Medium School School: St Anns english Medium school
City: Kolkata City: Kolkata
English %: 80 Board Roll No./Seat No.:
Aggregate Percentage: 61 School/College Code:
  Centre code:
  Address of School/College: 112belillious road howrah -1
  Pin: 711101
  Contact Nos:
  Email: st.annsemschool2010@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 ?: By doing part time job
Why do you wish to join TMI?: Because of good placements
What are your hobbies?: collecting coins
What are your strengths?: Focused
What are your weaknesses?: Family problems
How do you intend to meet the expenses of this program?: Other - by taking Money from relatives
 
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded 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 ________________

 
Print Summary and Application Form