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: DNS2175642 Name: ASHUTOSH DUBEY
  Address: Hno.-3710 Kalpanapuri Adityapur-1 Hno.-3710 Kalpanapuri Adityapur-1
Telephone No.: Mobile no: 6202828423
E-mail: dubeyashutosh1011@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: 428062712
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175642 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: DNS2175642
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: ASHUTOSH DUBEY
Mother's Name: Preeti Dubey
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Nov 2002 Nationality: Indian
Place of Birth: Buxar Bihar Personal Identification Mark: A cut mark on left upper eyebrow
Blood Group: O + Address for Communication: Hno.-3710 Kalpanapuri Adityapur-1 Hno.-3710 Kalpanapuri Adityapur-1
State: Jharkhand Country: India
Pin: 832109 City/District: SARAIKELA KHARSAWAN
Mobile no: 6202828423 Telephone No. with STD code:
Aadhar Card No: E-mail: dubeyashutosh1011@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: R K Dubey Relationship with candidate: Father
Parents Date of Birth: 20 Aug 1976 Parent's/Guardian's Occupation/Designation: Seafarer
   
Office Address:
   
Address: M. S. C House, Andheri Kurla Road, Andheri East, J. B Nagar, Mumbai, Maharashtra 400059 M. S. C House, Andheri Kurla Road, Andheri East, J. B Nagar, Mumbai, Maharashtra 400059
Country: India State: Maharashtra
City/District: Mumbai Pin: 400059
Tel: Mobile no.: 9031995079
Fax: Email: dubey22ramesh@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: ISCE
School: Rajendra Vidyalaya School: Rajendra Vidyalaya
City: Jamshedpur City: Jamshedpur
English %: 70 Board Roll No./Seat No.: 2201304/180
Aggregate Percentage: 70 School/College Code: jh023
  Centre code: 2213429
  Address of School/College: Subarnarekha Link Road , Sakchi
  Pin: 832109
  Contact Nos:
  Email: rv_jsr@yahoo.com
  Aggregate Percentage: 59
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 59 59
Chemistry 100 46 46
Mathematics 100 37 37
Physics, Chemistry & Mathematics combined Percentage: 47.33
English 100 74 74
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I would like to spend my time preparing for competitive exam , going to gym , playing football and exploring new places.
Why do you wish to join TMI?: I want to join Tolani Maritime Institute because it is one of the best maritime institute in India
What are your hobbies?: I like reading books , playing football and exploring new places
What are your strengths?: Positive attitude , Inovative , Persistance , Punctual , Flexible person
What are your weaknesses?: Emtionally attached , Straight forward , Trust people easily
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

 

___________________

Date ________________

 
Print Summary and Application Form