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: DNS2176708 Name: RUSHIKESH RAUT
  Address: 402/ A WING,BLUEBELL,NLGARDEN,ATLADARA,VADODARA 402/ A WING,BLUEBELL,NLGARDEN,ATLADARA,VADODARA
Telephone No.: Mobile no: 9374640477
E-mail: rushikesh_0411@yahoo.co.in  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: 427867603
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176708 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: DNS2176708
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: RUSHIKESH RAUT
Mother's Name: Swati Raut
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 04 Nov 2003 Nationality: INDIAN
Place of Birth: INDORE Personal Identification Mark: MOLE ON RIGHT PALM
Blood Group: B + Address for Communication: 402/ A WING,BLUEBELL,NLGARDEN,ATLADARA,VADODARA 402/ A WING,BLUEBELL,NLGARDEN,ATLADARA,VADODARA
State: Gujarat Country: India
Pin: 390012 City/District: VADODARA
Mobile no: 9374640477 Telephone No. with STD code:
Aadhar Card No:406098299703 E-mail: rushikesh_0411@yahoo.co.in
 
Guardian's Particulars:
 
Name of Parent/Guardian: PRASHANT RAUT Relationship with candidate: FATHER
Parents Date of Birth: 28 Nov 1972 Parent's/Guardian's Occupation/Designation: SERVICE
   
Office Address:
   
Address: SURVEY NO104 ON COASTAL HIGHWAY,POST MAHUVAD,TALUKA PADRA,VADODARA SURVEY NO104 ON COASTAL HIGHWAY,POST MAHUVAD,TALUKA PADRA,VADODARA
Country: India State: Gujarat
City/District: VADODARA Pin: 390012
Tel: 02652345355 Mobile no.: 9374640477
Fax: Email: rushikesh_0411@yahoo.co.in
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: BRIGHT DAY School: BRIGHT DAY
City: VADODARA City: VADODARA
English %: 89 Board Roll No./Seat No.: 00
Aggregate Percentage: 82 School/College Code: 00
  Centre code: 00
  Address of School/College: Vasna -Bhayli Main Road, Gotri-Vasna Road,Vadodara,Gujarat
  Pin: 390015
  Contact Nos: 9265854175
  Email: rushikesh_0411@yahoo.co.in
  Aggregate Percentage: 00
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 0 0
Chemistry 0 0
Mathematics 0 0
Physics, Chemistry & Mathematics combined Percentage: 0
English 0 0
   
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
02/2018 SKATING STATE LEVEL 1
02/2019 SKATING STATE LEVEL 2
02/2015 SKATING STATE LEVEL 2
05/2015 CARROM INTER SCHOOL 1
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I WOULD LIKE TO EXPLORE MORE ABOUT THE FIELD WHICH I AM JOINING AND DO MY HOBBIES
Why do you wish to join TMI?: THIS IS ONE OF THE REPUTED COLLEGES IN INDIA AND I WAS SUGGESTED BY MY FREIND WHO HAS PURSUED HIS CAREER FROM TMI
What are your hobbies?: PLAYING FOOTBALL , DOING SOME OUTDOOR ACTIVITIES
What are your strengths?: CONFIDENT , GREAT PHYSICALITY
What are your weaknesses?: NONE
How do you intend to meet the expenses of this program?: Own Resources
 
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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