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: DNS2174934 Name: Mukadam Basel Sameer
  Address: 1234 Royal Accord Rajapurkar Colony Udhyamnagar Ratnagiri
Telephone No.: 8888691555 Mobile no: 7397911177
E-mail: ibaselmukadam@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 DNS2174934 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: DNS2174934
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mukadam Basel Sameer
Mother's Name: Nasreen
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 07 Oct 2002 Nationality: Indian
Place of Birth: Ratnagiri Personal Identification Mark: on chin
Blood Group: B + Address for Communication: 1234 Royal Accord Rajapurkar Colony Udhyamnagar Ratnagiri
State: Maharashtra Country: India
Pin: 415612 City/District: Ratnagiri
Mobile no: 7397911177 Telephone No. with STD code: 8888691555
Aadhar Card No:998215168656 E-mail: ibaselmukadam@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sameer Mukadam Relationship with candidate: Father
Parents Date of Birth: 19 Apr 1974 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: 1234 Royal Accord Rajapurkar Colony Udhyamnagar Ratnagiri
Country: India State: Maharashtra
City/District: Ratnagiri Pin: 415612
Tel: 08888691555 Mobile no.: 8888691555
Fax: Email: sameermukadam@yahoo.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Maharashtra Board: Maharashtra
School: Sacred Heart Convent High School Udhyamnagar Ratnagiri School: A.K Junior College
City: Ratnagiri City: Ratnagiri
English %: 73 Board Roll No./Seat No.: W000235
Aggregate Percentage: 84 School/College Code: 0612
  Centre code: 0612
  Address of School/College: Adv.N.V.Joshi Road Near District Court Ratnagiri
  Pin: 415612
  Contact Nos: 02352222999
  Email: gjcrtn@gmail.com
  Aggregate Percentage: 55
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 54 54
Chemistry 100 39 39
Mathematics 100 49 49
Physics, Chemistry & Mathematics combined Percentage: 47.33
English 100 71 71
   
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
10/2018 Basketball National Basketball Championship Runnerup
04/2018 Basketball State Championship Participation
06/2018 Basketball State Championship Participation
04/2021 Basketball State Championship Participation
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Was engaged in extra curricular activities like playing Basketball, shaping my basketball skills , Did a stockmarket Course, Studied about Cyrpto Market .
Why do you wish to join TMI?: TMI is the best institute for DNS Course . TMI gives Guarantied Placements . TMI has a basketball Court too and has a Best basketball Team . I came to know about Tmi from Hitesh ranglani Sir
What are your hobbies?: BASKETBALL
What are your strengths?: Never Give up Attitude
What are your weaknesses?: Can never say no to anyone
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
 
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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