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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Meher manasi srivastava
Mother's Name: Sanjeeta srivastava
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 28 Jan 1999 Nationality: Indian
Place of Birth: Banda Personal Identification Mark: Moles on face
Blood Group: B + Address for Communication: 112, shankar market Near canal, bankat, chitrakoot
State: Uttar Pradesh Country: India
Pin: 210205 City/District: Chitrakoot
Mobile no: 9616740113 Telephone No. with STD code:
Aadhar Card No:836365067508 E-mail: mehersrivastava76@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Virendra kumar srivastava Relationship with candidate: Daughter
Parents Date of Birth: 05 Sep 1966 Parent's/Guardian's Occupation/Designation: Agriculture
   
Office Address:
   
Address: 112, shankar market Near canal, bankat, chitrakoot
Country: India State: Uttar Pradesh
City/District: Chitrakoot Pin: 210205
Tel: Mobile no.: 9616740113
Fax: Email: srivastavamanasi28@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: Year of Passing:
Board: Board:
School: School:
City: City:
English %: Board Roll No./Seat No.:
Aggregate Percentage: School/College Code:
  Centre code:
  Address of School/College:
  Pin:
  Contact Nos:
  Email:
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
Physics, Chemistry & Mathematics combined Percentage:
English
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
 
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded 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