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: Khaladkar om nandkumar
Mother's Name: Shraddha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Mar 2003 Nationality: Indian
Place of Birth: BARAMATI Personal Identification Mark: Black mole on right hand thumb
Blood Group: O + Address for Communication: 115/93 Navjyot Mahila Society Tambenagar Bhigwan road tandulwadi
State: Maharashtra Country: India
Pin: 413102 City/District: Pune
Mobile no: 7028820797 Telephone No. with STD code:
Aadhar Card No:318129982251 E-mail: omkhaladkar96@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Nandkumar khaladkar Relationship with candidate: Father
Parents Date of Birth: 01 Jun 1970 Parent's/Guardian's Occupation/Designation: Teaching
   
Office Address:
   
Address: 115/93 Navjyot Mahila Society Tambenagar Bhigwan road tandulwadi
Country: India State: Maharashtra
City/District: Pune Pin: 413102
Tel: Mobile no.: 8975062897
Fax: Email: khaladkarnr@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: Vidya pratishthan new english medium school School: Late Sahebrao Phadtare Higher Secondary School
City: Pune City: Pune
English %: 56 Board Roll No./Seat No.:
Aggregate Percentage: 80 School/College Code:
  Centre code:
  Address of School/College: Kalambh, pune
  Pin: 413102
  Contact Nos: 08975062897
  Email: khaladkarnr@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 ?: Not completed 12th exam yet
Why do you wish to join TMI?: It is the one of the best campus and also One of my uncle is seaferer so he told me
What are your hobbies?: Music, drawing
What are your strengths?: Discipline
What are your weaknesses?: Spontanity
How do you intend to meet the expenses of this program?: Own Resources
 
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