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: DNS2174282 Name: RAUSHAN RAJ
  Address: WARD NO. 38 CHHOTA BARIYARPUR PS-CHHATAUNI, MOTIHARI, EAST CHAMPARAN, BIHAR-845401
Telephone No.: Mobile no: 8538905271
E-mail: rajmth001@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425682463
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174282 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: DNS2174282
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: RAUSHAN RAJ
Mother's Name: RINA VERMA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 31 Jul 2003 Nationality: INDIAN
Place of Birth: MOTIHARI Personal Identification Mark: CUT ON CHIN
Blood Group: AB + Address for Communication: WARD NO. 38 CHHOTA BARIYARPUR PS-CHHATAUNI, MOTIHARI, EAST CHAMPARAN, BIHAR-845401
State: Bihar Country: India
Pin: 845401 City/District: MOTIHARI
Mobile no: 8538905271 Telephone No. with STD code:
Aadhar Card No:812188307511 E-mail: rajmth001@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: RAJU RANJAN VERMA Relationship with candidate: FATHER
Parents Date of Birth: 04 Feb 1975 Parent's/Guardian's Occupation/Designation: ARTIST
   
Office Address:
   
Address: WARD NO. 38 CHHOTA BARIYARPUR PS-CHHATAUNI, MOTIHARI, EAST CHAMPARAN, BIHAR-845401
Country: India State: Bihar
City/District: MOTIHARI Pin: 845401
Tel: Mobile no.: 9973308195
Fax: Email: RAJMTH001@GMAIL.COM
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: DEVASTHALIYA VIDYAPEETH School: DEVASTHALIYA VIDYAPEETH
City: MOTIHARI City: MOTIHARI
English %: 68 Board Roll No./Seat No.: 22615167
Aggregate Percentage: 66 School/College Code: 65577
  Centre code: 6550
  Address of School/College: AT-CHANDRAHIYA, MOTIHARI,EAST CHAMPARAN, BIHAR-845401
  Pin: 845401
  Contact Nos: 8538905271
  Email: RAJMTH001@GMAIL.COM
  Aggregate Percentage: 74
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 69 69
Chemistry 100 59 59
Mathematics 100 66 66
Physics, Chemistry & Mathematics combined Percentage: 64.67
English 100 82 82
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: PREPARING FOR IMUCET
Why do you wish to join TMI?: TO COMPLETE MY DNS COURSE
What are your hobbies?: READING AND PLAYING
What are your strengths?: MY STABILITY
What are your weaknesses?: VERY TALKATIVE
How do you intend to meet the expenses of this program?: Own Resources
 
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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