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: DNS2175188 Name: Amnesh Ranjan Tiwari
  Address: F-14 Hill view colony, JSPL Raigarh Chhattisgarh
Telephone No.: Mobile no: 7000957608
E-mail: amnes2507@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 426597639
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175188 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: DNS2175188
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Amnesh Ranjan Tiwari
Mother's Name: Annu Tiwari
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 25 Jul 2003 Nationality: Indian
Place of Birth: Raigarh Personal Identification Mark: Mole on right thigh
Blood Group: B + Address for Communication: F-14 Hill view colony, JSPL Raigarh Chhattisgarh
State: Chattisgarh Country: India
Pin: 496001 City/District: Raigarh
Mobile no: 7000957608 Telephone No. with STD code:
Aadhar Card No:628977142286 E-mail: amnes2507@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Akhileshwar Nath Tiwari Relationship with candidate: Father
Parents Date of Birth: 03 Mar 1972 Parent's/Guardian's Occupation/Designation: Private Service
   
Office Address:
   
Address: JSPL Raigarh
Country: India State: Chattisgarh
City/District: Raigarh Pin: 496001
Tel: Mobile no.: 7024168375
Fax: Email: akhilesh@jspl.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: O P Jindal School School: O P Jindal
City: RAIGARH City: Raigarh
English %: 91 Board Roll No./Seat No.:
Aggregate Percentage: 89 School/College Code:
  Centre code:
  Address of School/College: Kharsia Road, Raigarh, Chhattisgarh
  Pin: 496001
  Contact Nos:
  Email: opjsraigarh@jspl.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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
10/2019 Table Tennis Cbse Far East zone Participated
10/2016 Hockey Cbse Clusters Participated
11/2015 Hockey Cbse Clusters 3rd Position
11/2014 Interschool Music Competition Interschool First
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will go for some Adventure Sports . Will learn to play some musical instrument Learn some Computer Programming Language
Why do you wish to join TMI?: Because TMI is the best college for DNS.
What are your hobbies?: Playing Outdoor Games, Singing, Acting
What are your strengths?: I have leadership skills and teamwork spirit.
What are your weaknesses?: I am a bit less creative.
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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