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: DNS2175333 Name: Gaurav
  Address: Flat No. C-403 Eden Garden Garhi Bolni Road Rewari
Telephone No.: Mobile no: 9416577126
E-mail: BIREN216@GMAIL.COM  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 427638044
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175333 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: DNS2175333
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Gaurav
Mother's Name: Mukesh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Apr 2002 Nationality: Indian
Place of Birth: Rewari Personal Identification Mark: Burn mark on face at right side
Blood Group: O + Address for Communication: Flat No. C-403 Eden Garden Garhi Bolni Road Rewari
State: Haryana Country: India
Pin: 123401 City/District: Rewari
Mobile no: 9416577126 Telephone No. with STD code:
Aadhar Card No:324745925678 E-mail: BIREN216@GMAIL.COM
 
Guardian's Particulars:
 
Name of Parent/Guardian: BIREN KUMAR Relationship with candidate: FATHER
Parents Date of Birth: 06 May 1974 Parent's/Guardian's Occupation/Designation: LAWYER
   
Office Address:
   
Address: FLAT NO C-403 EDEN GARDEN GARHI BOLNI ROAD REWARI
Country: India State: Haryana
City/District: REWARI Pin: 123401
Tel: Mobile no.: 9416577126
Fax: Email: biren216@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: RPS PUBLIC SCHOOL BALIAR KALAN School: RPS PUBLIC SCHOOL
City: REWARI City: REWARI
English %: 76 Board Roll No./Seat No.:
Aggregate Percentage: 89 School/College Code:
  Centre code:
  Address of School/College: BALIAR KALAN DISTRICT REWARI
  Pin: 123401
  Contact Nos: 01274240645
  Email: RPSREWARI@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 FOR HIGHER STUDIES
Why do you wish to join TMI?: FOR A BRIGHT FUTURE
What are your hobbies?: STUDY AND PLAYING BADMINTON
What are your strengths?: FLEXIBILITY
What are your weaknesses?: SELF CRITISIM
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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