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: DNS2175571 Name: Saiyad Saeedadib Safiyuddin
  Address: Ajmatpura vadi bhathiji temple road hadgud, Anand, Gujarat, 388110
Telephone No.: Mobile no: 9725670291
E-mail: saeedadib.ss44@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 426383474
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175571 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: DNS2175571
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Saiyad Saeedadib Safiyuddin
Mother's Name: Saiyad Femidabibi Safiyuddin
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 May 2001 Nationality: Indian
Place of Birth: Anand Personal Identification Mark: A mole on chest
Blood Group: B + Address for Communication: Ajmatpura vadi bhathiji temple road hadgud, Anand, Gujarat, 388110
State: Gujarat Country: India
Pin: 388110 City/District: Anand
Mobile no: 9725670291 Telephone No. with STD code:
Aadhar Card No:468403278996 E-mail: saeedadib.ss44@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Saiyad Safiyuddin Saiyad Relationship with candidate: Father
Parents Date of Birth: 16 Aug 1973 Parent's/Guardian's Occupation/Designation: Government service / Farmer
   
Office Address:
   
Address: Post office motabajar Vallabh vidhyanagar
Country: India State: Gujarat
City/District: Anand Pin: 388120
Tel: Mobile no.: 9925377726
Fax: Email: safiyuddin.ss86@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Gujarat Board: Gujarat
School: Charotar English Medium School School: Charotar English Medium School
City: Anand City: Anand
English %: 78 Board Roll No./Seat No.: B103487
Aggregate Percentage: 82 School/College Code: 21126
  Centre code: 007
  Address of School/College: near old bus station, DN campus, Anand
  Pin: 388001
  Contact Nos:
  Email: cems@cesociety.in
  Aggregate Percentage: 66
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 150 103 68.67
Chemistry 150 101 67.33
Mathematics 100 69 69
Physics, Chemistry & Mathematics combined Percentage: 68.33
English 100 53 53
   
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
01/2016 skating districl level first
02/2016 skating district level second
01/2018 vollyball district level first
01/2018 running district level second
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
12/2017 NCC camp 10 days
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Revising 12 standard, reading religious book, doing work at farm, staying at home because of COVID-19
Why do you wish to join TMI?: Because it is the best institute/collage according to me.
What are your hobbies?: volleyball, skating, travelling
What are your strengths?: work with dedication, hardworking, confident
What are your weaknesses?: sometime not satisfy
How do you intend to meet the expenses of this program?: Bank Loan
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate Class XII admit card Class XII marksheet
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

___________________

Date ________________

 
Print Summary and Application Form