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: DNS2175183 Name: Sameer Debaraja Pedini
  Address: Room No 82,Chawl No 3 Janata Nagar Chembur, Mumbai 400089
Telephone No.: Mobile no: 9326567791
E-mail: sameepedini@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 426286102
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175183 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________

   
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: DNS2175183
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Sameer Debaraja Pedini
Mother's Name: Labanyabati
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Jun 2002 Nationality: Indian
Place of Birth: Orissa Personal Identification Mark: No
Blood Group: B + Address for Communication: Room No 82,Chawl No 3 Janata Nagar Chembur, Mumbai 400089
State: Maharashtra Country: India
Pin: 400089 City/District: Mumbai
Mobile no: 9326567791 Telephone No. with STD code:
Aadhar Card No:348221935482 E-mail: sameepedini@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Debaraja Pedini Relationship with candidate: Son
Parents Date of Birth: 12 Apr 1978 Parent's/Guardian's Occupation/Designation: Service
   
Office Address:
   
Address: No No
Country: India State: Maharashtra
City/District: Mumbai Pin: 400089
Tel: Mobile no.: 9326567791
Fax: Email: sameepedini@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: Chembur Karnataka high school School: S.K Somaiya Vinaymandir Junior College
City: Mumbai City: Mumbai
English %: 80 Board Roll No./Seat No.:
Aggregate Percentage: 82 School/College Code:
  Centre code:
  Address of School/College: Vidyavihar,Mumbai
  Pin: 400077
  Contact Nos:
  Email: s.pedini@somaiya.edu
  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 ?: By playing
Why do you wish to join TMI?: Because of its state of the art infrastructure, their faculties and ocean of opportunities
What are your hobbies?: Cricket,football
What are your strengths?: To trust anyone very quickly or blindly
What are your weaknesses?: Sometimes my strengths tends to be my weakness
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan
 
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 ________________

 
Print Summary and Application Form