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: DNS2176638 Name: Mritunjay Patidar
  Address: 126-A Royal Residency Mhow, Indore, Madhya Pradesh
Telephone No.: Mobile no: 6232799260
E-mail: mritunjay4111@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 436815029
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176638 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: DNS2176638
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mritunjay Patidar
Mother's Name: Sulekha Patidar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 26 Mar 2002 Nationality: INDIAN
Place of Birth: Khargone Personal Identification Mark: Mole on lower lip
Blood Group: B + Address for Communication: 126-A Royal Residency Mhow, Indore, Madhya Pradesh
State: Madhya Pradesh Country: India
Pin: 453441 City/District: Indore
Mobile no: 6232799260 Telephone No. with STD code:
Aadhar Card No:927546763171 E-mail: mritunjay4111@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Kailash Patidar Relationship with candidate: Father
Parents Date of Birth: 06 Mar 1978 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: 126-A Royal Residency Mhow, Indore, Madhya Pradesh
Country: India State: Madhya Pradesh
City/District: Indore Pin: 453441
Tel: Mobile no.: 9977759021
Fax: Email: mritunjay4111@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Madhya Pradesh Board: Madhya Pradesh
School: Mehar Public H.S. School School: Mehar Public H.S. School
City: Indore City: Indore
English %: 70 Board Roll No./Seat No.: 205333640
Aggregate Percentage: 73 School/College Code: 532439
  Centre code: 531049
  Address of School/College: Vishwas Nagar, Indore
  Pin: 453441
  Contact Nos: 6232799260
  Email: mritunjay4111@gmail.com
  Aggregate Percentage: 67
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 075 75
Chemistry 100 059 59
Mathematics 100 062 62
Physics, Chemistry & Mathematics combined Percentage: 65.33
English 100 061 61
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I be grabbing more and more knowledge about merchant navy about syllabus and about sea life.
Why do you wish to join TMI?: I do wish to join TMI because TMI is one of the oldest and reputative Institute in India and I want to part of this Institute.
What are your hobbies?: My hobbies are playing volleyball and swimming.
What are your strengths?: My Strength is my positive Attitude towards any work I do.
What are your weaknesses?: My weakness is I became restless when my work is left Incomplete.
How do you intend to meet the expenses of this program?: Bank Loan
 
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

 

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Date ________________

 
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