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: DNS2176868 Name: SATYAM VISHWAKARMA
  Address: PATNA CHAURAHA, MUKTI PATH ROAD, BARHALGANJ, CHILLUPAR, GORAKHPUR, UTTAR PRADESH PATNA CHAURAHA, MUKTI PATH ROAD, BARHALGANJ, CHILLUPAR, GORAKHPUR, UTTAR PRADESH
Telephone No.: Mobile no: 9651033769
E-mail: satyamvishwakarma151@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 427691576
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176868 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: DNS2176868
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: SATYAM VISHWAKARMA
Mother's Name: PUSHPA VISHWAKARMA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Mar 2003 Nationality: INDIAN
Place of Birth: BARHALGANJ Personal Identification Mark: MOLE
Blood Group: O + Address for Communication: PATNA CHAURAHA, MUKTI PATH ROAD, BARHALGANJ, CHILLUPAR, GORAKHPUR, UTTAR PRADESH PATNA CHAURAHA, MUKTI PATH ROAD, BARHALGANJ, CHILLUPAR, GORAKHPUR, UTTAR PRADESH
State: Uttar Pradesh Country: India
Pin: 273402 City/District: GORAKHPUR
Mobile no: 9651033769 Telephone No. with STD code:
Aadhar Card No:972806735666 E-mail: satyamvishwakarma151@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: RAKESH VISHWAKARMA Relationship with candidate: FATHER
Parents Date of Birth: 01 Jul 1974 Parent's/Guardian's Occupation/Designation: BUSINESSMAN
   
Office Address:
   
Address: PATNA CHAURAHA, MUKTI PATH ROAD, BARHALGANJ, CHILLUPAR, GORAKHPUR, UTTAR PRADESH PATNA CHAURAHA, MUKTI PATH ROAD, BARHALGANJ, CHILLUPAR, GORAKHPUR, UTTAR PRADESH
Country: India State: Uttar Pradesh
City/District: GORAKHPUR Pin: 273402
Tel: Mobile no.: 9450888428
Fax: Email: rakeshvishwakarma9450@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: ST.JOSEPH SCH SCHOOL School: ST.JOSEPH SCH SCHOOL
City: GORAKHPUR City: GORAKHPUR
English %: 84 Board Roll No./Seat No.: 23641777
Aggregate Percentage: 73 School/College Code: 70532
  Centre code: 7117
  Address of School/College: ST.JOSEPH SCH SCHOOL BARHALGANJ VILL KODARI GORAKHPUR
  Pin: 273402
  Contact Nos: 05525280142
  Email: sjsbarhalganj@rediffmail.com
  Aggregate Percentage: 68
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 67 67
Chemistry 100 69 69
Mathematics 100 61 61
Physics, Chemistry & Mathematics combined Percentage: 65.67
English 100 73 73
   
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
11/2019 VOLLEY BALL SCHOOL FIRST
10/2019 CHESS SCHOOL THIRD
11/2015 CHESS SCHOOL FIRST
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: DOING ONLINE COACHING , HELPING FATHER IN BUSINESS AND DOING CREATIVITY.
Why do you wish to join TMI?: LESS FEE STRUCTURE FOR DNS COURSE,GOOD PLACEMENT JOB.
What are your hobbies?: PLAYING CHESS, READING BOOKS.
What are your strengths?: I AM A HARDWORKING AND TEAMWORKING PERSON.
What are your weaknesses?: I FILL BAD WHEN I DID NOT FINISH MY WORK ON A GIVEN TIME
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 Class XII admit card Class XII marksheet
 
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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