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: DNS2175724 Name: RAZA ALI FAROOQUI
  Address: VILL-BIKOPUR, PO-KOTHI, PS-KOTHI DIST-GAYA, STATE-BIHAR
Telephone No.: Mobile no: 9430310065
E-mail: razaalifarooqui@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 426451701
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175724 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: DNS2175724
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: RAZA ALI FAROOQUI
Mother's Name: NAFISA PARWEEN
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Feb 2001 Nationality: INDIAN
Place of Birth: BIKOPUR Personal Identification Mark: MOLE IN RIGHT HAND
Blood Group: A + Address for Communication: VILL-BIKOPUR, PO-KOTHI, PS-KOTHI DIST-GAYA, STATE-BIHAR
State: Bihar Country: India
Pin: 824210 City/District: GAYA
Mobile no: 9430310065 Telephone No. with STD code:
Aadhar Card No:813754309948 E-mail: razaalifarooqui@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: RAZIUL KARIM Relationship with candidate: FATHER
Parents Date of Birth: 15 Jan 1969 Parent's/Guardian's Occupation/Designation: FARMER
   
Office Address:
   
Address: VILL-BIKOPUR, PO-KOTHI, PS-KOTHI DIST-GAYA, STATE-BIHAR
Country: India State: Bihar
City/District: GAYA Pin: 824210
Tel: Mobile no.: 9430310065
Fax: Email: razaalifarooqui@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2021
Board: Jharkand Board: Jharkand
School: S S HIGH SCHOOL GUMLA School: PAMPAPUR INTER COLLEGE PALKOT
City: GUMLA City: PALKOT
English %: 77 Board Roll No./Seat No.:
Aggregate Percentage: 64 School/College Code:
  Centre code:
  Address of School/College: PAMPAPUR INTER COLLEGE PALKOT
  Pin: 835220
  Contact Nos: 9431328121
  Email: razaalifarooqui@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 ?: I intend spending my time after completing class XII Finall exams and before joining college, Travelling and Photoshoot.
Why do you wish to join TMI?: It is obviously the best institute in India or even Asia, with the maximum training, knowledge and placement percentage, it is half way to success.
What are your hobbies?: Painting, Cycling, Traveling, Photography
What are your strengths?: My strength is not to give up.
What are your weaknesses?: I am not very in expressing that I actually feel.
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 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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