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: DNS2174702 Name: MADHAV CHAWLA
  Address: 20 PUNNET VIHAR EXTENSION NEAR SHEKHAR RESIDENCY PASCHIM PURI AGRA 20 PUNNET VIHAR EXTENSION NEAR SHEKHAR RESIDENCY
Telephone No.: Mobile no: 9634565444
E-mail: mamtachawla1974@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 426063932
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174702 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: DNS2174702
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: MADHAV CHAWLA
Mother's Name: MAMTA CHAWLA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Aug 2002 Nationality: INDIA
Place of Birth: AGRA Personal Identification Mark: only shoulder
Blood Group: O + Address for Communication: 20 PUNNET VIHAR EXTENSION NEAR SHEKHAR RESIDENCY PASCHIM PURI AGRA 20 PUNNET VIHAR EXTENSION NEAR SHEKHAR RESIDENCY
State: Uttar Pradesh Country: India
Pin: 282007 City/District: AGRA
Mobile no: 9634565444 Telephone No. with STD code:
Aadhar Card No: E-mail: mamtachawla1974@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SHYAM CHAWLA Relationship with candidate: FATHER
Parents Date of Birth: 31 Jul 1971 Parent's/Guardian's Occupation/Designation: GOVERNMENT JOB
   
Office Address:
   
Address: ELECTION OFFICE,COLLECTORATE,MG ROAD AGRA ELECTION OFFICE,COLLECTORATE,MG ROAD AGRA
Country: India State: Uttar Pradesh
City/District: AGRA Pin: 282007
Tel: Mobile no.: 9411603786
Fax: Email: mamtachawla1974@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: DR MARIA RESIDENTIAL ACADEMY School: DR MARIA RESINDENTIAL ACADEMY
City: AGRA City: AGRA
English %: 75 Board Roll No./Seat No.:
Aggregate Percentage: 83 School/College Code:
  Centre code:
  Address of School/College: DR. MARIA RESIDENTIAL ACADWMY SIKANDARA BODLA AGRA UTTAR PRADESH
  Pin: 282007
  Contact Nos:
  Email: mdixit.488@rediffmail.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 ?: TO LEARN NEW SKILLS
Why do you wish to join TMI?: TOLANI MARITIME INSTITUTE IS ONE OF THE LARGEST MARITIME EDUCATIONAL CENTRES OFFERING NAUTICAL SCIENCE DEGREE PROGRAMS.
What are your hobbies?: My hobbies is playing football and reading books
What are your strengths?: ABILITY TO WORK IN A TEAM
What are your weaknesses?: SOFT SKILLS
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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