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: DNS2174369 Name: Prashant Pal
  Address: plot no. 10,New ashok nagar , kalyanpur , kanpur plot no 10 ,new ashok nagar , kalyanpur ,kanpur
Telephone No.: Mobile no: 9005604608
E-mail: masterprashant.lifeatsea@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 432001940
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174369 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: DNS2174369
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Prashant Pal
Mother's Name: Mrs Meena Pal
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Apr 2004 Nationality: Indian
Place of Birth: hospital Personal Identification Mark: mole on left shoulder
Blood Group: O + Address for Communication: plot no. 10,New ashok nagar , kalyanpur , kanpur plot no 10 ,new ashok nagar , kalyanpur ,kanpur
State: Uttar Pradesh Country: India
Pin: 208017 City/District: kanpur
Mobile no: 9005604608 Telephone No. with STD code:
Aadhar Card No:834755757186 E-mail: masterprashant.lifeatsea@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Mr Rajesh Pal Relationship with candidate: Father
Parents Date of Birth: 01 Apr 1976 Parent's/Guardian's Occupation/Designation: private buissness
   
Office Address:
   
Address: plot no 10 ,new ashok nagar ,kalyanpur,kanpur plot no 10,new ashok nagar ,kalyanpur,kanpur
Country: India State: Uttar Pradesh
City/District: kanpur Pin: 208017
Tel: Mobile no.: 9005604606
Fax: Email: masterprashant.lifeatsea@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Gaurav Memorial International School School: Gaurav Memorial International School
City: kanpur City: kanpur
English %: 94 Board Roll No./Seat No.:
Aggregate Percentage: 88 School/College Code:
  Centre code:
  Address of School/College: 673,BITHOOR ROAD,KALYANPUR ,KANPUR
  Pin: 208026
  Contact Nos:
  Email: gmischool05@yahoo.co.in
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
11/2018 cricket kss inter school competition participation
11/2016 long jump inter house competition third position
08/2016 cricket kss inter school competition participation
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: buy collecting more and more information about the college and prepare myself for the future circumstances
Why do you wish to join TMI?: because it is the best college with a moderate level of fees and a better placement record
What are your hobbies?: listening music and exploring world map
What are your strengths?: i have a great habbit of making friends in a very less time
What are your weaknesses?: i wake up late in the morning
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 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

 

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Date ________________

 
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