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: DNS2174062 Name: PANKAJ GIRI GOSWAMI
  Address: J C PURAM BITHORIA NO. 2 PO. KATHGHARIA
Telephone No.: Mobile no: 7456891057
E-mail: pg8141365@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425599756
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174062 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: DNS2174062
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PANKAJ GIRI GOSWAMI
Mother's Name: PUSHPA GIRI GOSWAMI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Jun 2003 Nationality: INDIAN
Place of Birth: KAPILESHWAR Personal Identification Mark: INJURY MARK ON FOREHEAD
Blood Group: B + Address for Communication: J C PURAM BITHORIA NO. 2 PO. KATHGHARIA
State: Uttaranchal Country: India
Pin: 263139 City/District: HALDWANI
Mobile no: 7456891057 Telephone No. with STD code:
Aadhar Card No:471142897653 E-mail: pg8141365@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: RAMESH GIRI GOSWAMI Relationship with candidate: FATHER
Parents Date of Birth: 19 Jun 1969 Parent's/Guardian's Occupation/Designation: CARPENTER
   
Office Address:
   
Address: JC PURAM BITHORIA NO. 2 PO. KATHGHARIA
Country: India State: Uttaranchal
City/District: HALDWANI Pin: 263139
Tel: Mobile no.: 8191829904
Fax: Email: goswamipankaj006@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: GURUKUL INTERNATIONAL SCHOOL School: GURUKUL INTERNATIONAL SCHOOL
City: HALDWANI City: HALDWANI
English %: 84 Board Roll No./Seat No.: 25625706
Aggregate Percentage: 86 School/College Code: 81121
  Centre code: 8105
  Address of School/College: KALADHUNGI BYPASS KAMALUAGANJA HALDWANI NAINITAL
  Pin: 263139
  Contact Nos:
  Email: gurukul.international@rediffmail.com
  Aggregate Percentage: 72
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 74 74
Chemistry 100 63 63
Mathematics 100 53 53
Physics, Chemistry & Mathematics combined Percentage: 63.33
English 100 87 87
   
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
2018 ESSAY WRITING INTRASCHOOL FIRST
2019 HINDI LANGUAGE NATIONAL FIRST
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I was planning to start my career in merchant Navy
Why do you wish to join TMI?: TMI is ranked no. 1 . Everyone wants to start their career from a reputed college and company and TMI stands well in both so I want to start my career from TMI
What are your hobbies?: Writing learning and playing games
What are your strengths?: I am curious I want to know everything I m disciplined I m trustworthy and responsible person
What are your weaknesses?: I am weak in communication skills but i am overcoming it by
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 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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