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: DNS2174849 Name: Pereira Prince Custodio
  Address: Maria mansion F-ward Salaiwada sawantwadi Sindhudurg Maharashtra
Telephone No.: Mobile no: 9763689108
E-mail: princepereira03@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 DNS2174849 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: DNS2174849
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Pereira Prince Custodio
Mother's Name: Cinderella
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 24 Dec 2003 Nationality: India
Place of Birth: Sawantwadi Personal Identification Mark: Curly hay
Blood Group: A + Address for Communication: Maria mansion F-ward Salaiwada sawantwadi Sindhudurg Maharashtra
State: Maharashtra Country: India
Pin: 416510 City/District: Sawantwadi Sindhudurg
Mobile no: 9763689108 Telephone No. with STD code:
Aadhar Card No:975374414033 E-mail: princepereira03@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Custodio Pereira Relationship with candidate: Father
Parents Date of Birth: 17 Dec 1975 Parent's/Guardian's Occupation/Designation: Mechanical Engineer
   
Office Address:
   
Address: Sawantwadi Sindhudurg
Country: India State: Maharashtra
City/District: Sawantwadi Sindhudurg Pin: 416510
Tel: Mobile no.: 9422055237
Fax: Email: custodio.pereira69@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: Milagris high school School: RSB jr college
City: Sawantwadi City: Sawantwadi
English %: 76 Board Roll No./Seat No.:
Aggregate Percentage: 86 School/College Code:
  Centre code:
  Address of School/College: Opp. Moti talav , rameshwar plaza , sawantwadi
  Pin: 416510
  Contact Nos:
  Email: princepereira03@gmail.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 ?: Preparation of IMUCET and visiting companies and colleges
Why do you wish to join TMI?: To perform DNS course and make career with them
What are your hobbies?: Swimming and cycling
What are your strengths?: Calm minded and passionate
What are your weaknesses?: Emotional
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 not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

___________________

Date ________________

 
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