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: DNS2174829 Name: satyam kushwaha
  Address: vill.-isipur malawan khurd jhunsi prayagraj
Telephone No.: Mobile no: 7784876635
E-mail: satyamkushwaha850@gmail.com  
   
Application fee payment details:  
Payment Status: Offline Payment Mode: Offline
Amount: DD Number: -
Issuing Bank: - Transaction Id: -
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174829 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: DNS2174829
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: satyam kushwaha
Mother's Name: meena kushwaha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 Jul 2000 Nationality: Indian
Place of Birth: allahabad Personal Identification Mark: cut mark on nose
Blood Group: O + Address for Communication: vill.-isipur malawan khurd jhunsi prayagraj
State: Uttar Pradesh Country: India
Pin: 211019 City/District: prayagraj
Mobile no: 7784876635 Telephone No. with STD code:
Aadhar Card No:644349394112 E-mail: satyamkushwaha850@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: kundan singh kushwaha Relationship with candidate: father
Parents Date of Birth: 01 Jan 1977 Parent's/Guardian's Occupation/Designation: farmer
   
Office Address:
   
Address: vill.-isipur malawan khurd jhunsi prayagraj
Country: India State: Uttar Pradesh
City/District: prayagraj Pin: 211019
Tel: Mobile no.: 8577938187
Fax: Email: baijnathkushwaha123@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2016 Year of Passing: 2018
Board: Uttar Pradesh Board: Uttar Pradesh
School: vikas i c palnagar sahson School: vikas i c palnagar sahson
City: prayagraj City: prayagraj
English %: 90 Board Roll No./Seat No.: 1595562
Aggregate Percentage: 90 School/College Code: 1535
  Centre code: 1959
  Address of School/College: VIKAS-I-C-PALNAGAR-SAHSON-ALLAHABAD
  Pin: 221507
  Contact Nos:
  Email: kingrahulkk420@gmail.com
  Aggregate Percentage: 57
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 53 53
Chemistry 100 62 62
Mathematics 100 33 33
Physics, Chemistry & Mathematics combined Percentage: 49.33
English 100 62 62
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: learn or read some extra courses/classes
Why do you wish to join TMI?: good in class
What are your hobbies?: drawing,gaming,book reading
What are your strengths?: ebucation,healthy body
What are your weaknesses?: emotion
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

 

___________________

Date ________________

 
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