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: DNS2177060 Name: Ayush Srivastava
  Address: Near Hp Gas Agency and venkat tower , Retired colony Chakradharpur, Jharkhand
Telephone No.: Mobile no: 9334727194
E-mail: ayushsrv21@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: 428121142
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2177060 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: DNS2177060
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Ayush Srivastava
Mother's Name: Geeta Srivastava
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Dec 2003 Nationality: Indian
Place of Birth: Jamshedpur Personal Identification Mark: a mole on right hand ring finger
Blood Group: AB + Address for Communication: Near Hp Gas Agency and venkat tower , Retired colony Chakradharpur, Jharkhand
State: Jharkhand Country: India
Pin: 833102 City/District: Chakradarpur
Mobile no: 9334727194 Telephone No. with STD code:
Aadhar Card No:368831198575 E-mail: ayushsrv21@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rajesh Kumar Srivastava Relationship with candidate: son
Parents Date of Birth: 12 Oct 1964 Parent's/Guardian's Occupation/Designation: Government Employe
   
Office Address:
   
Address: Near HP Gas Agency Retired Colony , Chakradharpur ,Jharkhand
Country: India State: Jharkhand
City/District: Chakradharpur Pin: 833102
Tel: Mobile no.: 9334727194
Fax: 18 Email: ayushsrv21@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: CBSE
School: South Eastern Railway English Medium School School: DAV Public School
City: Chakradharpur City: Jamshedpur
English %: 83 Board Roll No./Seat No.:
Aggregate Percentage: 80 School/College Code:
  Centre code:
  Address of School/College: Road no.4,contractors area ,Bistupur ,Jamshedpur,Jharkhand
  Pin: 831001
  Contact Nos: 9334727194
  Email: ayushsrv21@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
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
12/2011 Karate State level 1st
12/2011 Karate State level 3rd
05/2018 Cricket District level Under 16yrs Team
05/2019 Cricket District level Under 16yrs Team
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will work on my hobbies which is Reading Novels and Playing Cricket.
Why do you wish to join TMI?: The main reason to join TMI is that, it is a highly reputed and most disciplined merchant navy institution of our country and it has global standards of training.
What are your hobbies?: Reading Novels and Playing Cricket .
What are your strengths?: I consider my strengths, that i have the curiosity to learn new things and i can handle the pressure situation efficiently.
What are your weaknesses?: My weakness is my extra socialising nature.
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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