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: DNS2177993
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Sumeet kumar jena
Mother's Name: Ritanjali jena
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Nov 2003 Nationality: Indian
Place of Birth: Cuttack Personal Identification Mark: No
Blood Group: B + Address for Communication: CDA Sector 10 plot no. 4d 1037 Cuttack CDA Sector 10 plot no. 4d 1037 Cuttack CDA Sector 10 plot no. 4d 1037 Cuttack
State: Orissa Country: India
Pin: 753014 City/District: Cuttack
Mobile no: 7608089762 Telephone No. with STD code:
Aadhar Card No:370602585007 E-mail: pikunjena0074@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Akshaya kumar jena Relationship with candidate: Father
Parents Date of Birth: 01 Nov 1971 Parent's/Guardian's Occupation/Designation: Government servant
   
Office Address:
   
Address: Aurobinda Nagar madhupatna Cuttack Aurobinda Nagar madhupatna Cuttack Aurobinda Nagar madhupatna Cuttack
Country: India State: Orissa
City/District: Cuttack Pin: 753010
Tel: Mobile no.: 9937596212
Fax: Email: sumeetjena1234@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Dav public school CDA Sector 6 abhinav bidanasi cuttack School: Dav public school CDA Sector 6 abhinav bidanasi Cuttack
City: Cuttack City: Cuttack
English %: 81 Board Roll No./Seat No.:
Aggregate Percentage: 86 School/College Code:
  Centre code:
  Address of School/College: CDA Sector 6 abhinav bidanasi Cuttack
  Pin: 753014
  Contact Nos:
  Email: davcda2004@yahoo.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:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will work on myself like I will do my communication skills strong
Why do you wish to join TMI?: Leadership quality and dedicated towards work
What are your hobbies?: Jogging and dancing
What are your strengths?: Honesty and leadership quality
What are your weaknesses?: Take on too much responsibilities
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

 

___________________

Date ________________

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