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: DNS2175067 Name: Shubham Kumar
  Address: HIG/159, Hari OM Nagar, Road no.- 5, Adityapur, Saraikela Kharsawan HIG/159, Hari OM Nagar, Road no.- 5, Adityapur, Saraikela Kharsawan
Telephone No.: Mobile no: 6299238280
E-mail: shubhamkmr1234567@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 426783139
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175067 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: DNS2175067
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Shubham Kumar
Mother's Name: Lata Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Mar 2002 Nationality: India
Place of Birth: Nawagarh Personal Identification Mark: Mole on right shin
Blood Group: O + Address for Communication: HIG/159, Hari OM Nagar, Road no.- 5, Adityapur, Saraikela Kharsawan HIG/159, Hari OM Nagar, Road no.- 5, Adityapur, Saraikela Kharsawan
State: Jharkhand Country: India
Pin: 831013 City/District: Saraikela Kharsawan
Mobile no: 6299238280 Telephone No. with STD code:
Aadhar Card No:323559963243 E-mail: shubhamkmr1234567@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sudhir Kumar Relationship with candidate: Father
Parents Date of Birth: 10 Jan 1968 Parent's/Guardian's Occupation/Designation: Engineer
   
Office Address:
   
Address: HIG/159, Hari OM Nagar, Road no.- 5, Adityapur, Saraikela Kharsawan HIG/159, Hari OM Nagar, Road no.- 5, Adityapur, Saraikela Kharsawan
Country: India State: Jharkhand
City/District: Saraikela Kharsawan Pin: 831013
Tel: Mobile no.: 9934807651
Fax: Email: shubhamkmr1234567@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: D.A.V. Public School Bistupur School: D.A.V. Public School
City: Jamshedpur City: Jamshedpur
English %: 87 Board Roll No./Seat No.: 22695091
Aggregate Percentage: 82 School/College Code: 66332
  Centre code: 6793
  Address of School/College: D.A.V. Public School, Bistupur, Jamshedpur
  Pin: 831001
  Contact Nos:
  Email: shubhamkmr1234567@gmail.com
  Aggregate Percentage: 63
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 65 65
Chemistry 100 53 53
Mathematics 100 49 49
Physics, Chemistry & Mathematics combined Percentage: 55.67
English 100 78 78
   
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
04/2017 Guitar Diploma 2nd
05/2011 Football Zonal Quarter Finals
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Learning more and more about the field from my friends in the same field while studying.
Why do you wish to join TMI?: Because TMI is the best maritime academy in India.
What are your hobbies?: Mountain Biking, Playing Guitar, Playing Video Games
What are your strengths?: Will power, determination, confidence, social skills
What are your weaknesses?: Sometimes taking things lightly
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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