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: DNS2176301
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: UTKARSH SHUKLA
Mother's Name: NEELAM SHUKLA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 Sep 2001 Nationality: INDIAN
Place of Birth: PRAYAGRAJ Personal Identification Mark: CUT MARK NEAR RIGHT EYE
Blood Group: B + Address for Communication: 180/11A MARG NO.7
State: Uttar Pradesh Country: India
Pin: 211011 City/District: PRAYAGRAJ
Mobile no: 8009065404 Telephone No. with STD code:
Aadhar Card No:923956206082 E-mail: utra2027@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: NEELAM SHUKLA Relationship with candidate: MOTHER
Parents Date of Birth: 30 Apr 1979 Parent's/Guardian's Occupation/Designation: NIL
   
Office Address:
   
Address: NIL NIL
Country: India State: Uttar Pradesh
City/District: PRAYAGRAJ Pin: 211011
Tel: Mobile no.: 8545036270
Fax: Email: shuklau05@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2015 Year of Passing: 2019
Board: CBSE Board: Uttar Pradesh
School: VISHNU BHAGWAN PUBLIC SCHOOL School: R P ACADEMY GOVINDPURAM COD GATE NAINI
City: PRAYAGRAJ City: PRAYAGRAJ
English %: 76 Board Roll No./Seat No.: 1418309
Aggregate Percentage: 64 School/College Code: 1942
  Centre code: 04970
  Address of School/College: GOVINDPURAM COD GATE NAINI
  Pin: 211008
  Contact Nos: 9935762300
  Email: shuklau05@gmail.com
  Aggregate Percentage: 68
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 82 82
Chemistry 100 82 82
Mathematics 100 54 54
Physics, Chemistry & Mathematics combined Percentage: 72.67
English 100 75 75
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: WORK HARD FOR COLLECTING MONEY, TO JOIN MERCHANY NAVY COLLEGE.
Why do you wish to join TMI?: FOR THE BEST STUDIES AND EXTRA CURRICULUM ACTIVITES. OPPORTUNITIES TO JOIN BEST COMPANIES
What are your hobbies?: PLAYING CRICKET
What are your strengths?: MY STRENGTH IS PROBABLY THE ABILITY TO DEAL WITH PEOPLE.
What are your weaknesses?: being to helpful
How do you intend to meet the expenses of this program?: Own Resources
 
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 ________________

 
Last date for payment of application fees has passed. No further application fee payment will be accepted.