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: DNS2176070 Name: Ajay Jagadeesh
  Address: Sri Lakshmi Saroj Naidu Layout, Kuvempu Nagar Jalahalli East, Bangalore 560014
Telephone No.: Mobile no: 9036834374
E-mail: ajuaanda2003@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 431597221
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176070 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: DNS2176070
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Ajay Jagadeesh
Mother's Name: Sumathy
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 19 Dec 2003 Nationality: Indian
Place of Birth: Palakkad Personal Identification Mark: a black mole in right wrist
Blood Group: O + Address for Communication: Sri Lakshmi Saroj Naidu Layout, Kuvempu Nagar Jalahalli East, Bangalore 560014
State: Karnataka Country: India
Pin: 560014 City/District: BANGALORE URBAN
Mobile no: 9036834374 Telephone No. with STD code:
Aadhar Card No:206316374293 E-mail: ajuaanda2003@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Jagadeesh Manmohan Relationship with candidate: Father
Parents Date of Birth: 30 Jul 1963 Parent's/Guardian's Occupation/Designation: Ex-Service man
   
Office Address:
   
Address: sri lakshmi saroj 10th cross,Naidu Layout Jalahalli East,Bangalore 560014
Country: India State: Karnataka
City/District: BANGALORE Pin: 560014
Tel: Mobile no.: 9611940915
Fax: Email: jagadeesh_manmohan@yahoo.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Kendriya Vidyalaya No.2 AFS Jalahalli East School: KENDRIYA VIDYALAYA NO2 AFS
City: BANGALORE City: BANGALORE
English %: 82 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Centre code:
  Address of School/College: 226, 10th cross Naidu Layout, Jalahalli East, Bangalore 560014
  Pin: 560014
  Contact Nos: 9036834374
  Email: ajuaanda2003@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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
10/2016 Hand Ball Nationals Participation
08/2016 Hand Ball Regional First
08/2015 Hand Ball Regional Second
07/2015 Hand Ball School First
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
07/2018 Rajya Puraskar 7 days
08/2017 Tritya Sopan 3 days
10/2016 Dwitya Sopan 3 days
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: going for cycling and gaining knowledge of astrology
Why do you wish to join TMI?: 1.I am not much social 2.Have experience of staying away from my family at multiple occasions 3.i have developed the quality of adaption all these factors make me a perfect candidate for this field
What are your hobbies?: gaining knowledge of astrology
What are your strengths?: My friends
What are your weaknesses?: Laziness
How do you intend to meet the expenses of this program?: Own Resources,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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