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: DNS2178425
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Gourav Rathore
Mother's Name: Kiran
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Apr 2004 Nationality: Indian
Place of Birth: Ratlam Personal Identification Mark: Mole on right hand
Blood Group: B + Address for Communication: MIG-45, Dongre Nagar, behind Hanuman temple MIG-45, Dongre Nagar, behind Hanuman temple
State: Madhya Pradesh Country: India
Pin: 457001 City/District: Ratlam
Mobile no: 7470444565 Telephone No. with STD code:
Aadhar Card No:684682559486 E-mail: gouravrathorr@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Om Prakash Relationship with candidate: Father
Parents Date of Birth: 05 Jan 1996 Parent's/Guardian's Occupation/Designation: Private Service
   
Office Address:
   
Address: MIG-45, Dongre Nagar, behind Hanuman temple MIG-45, Dongre Nagar, behind Hanuman temple
Country: India State: Madhya Pradesh
City/District: Ratlam Pin: 457001
Tel: Mobile no.: 9329027565
Fax: Email: gouravrathorr@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Samta Shiksha Niketan School: Samta Shiksha Niketan
City: Ratlam City: Ratlam
English %: 77 Board Roll No./Seat No.:
Aggregate Percentage: 74 School/College Code:
  Centre code:
  Address of School/College: Bhagwan Mahavir marg, sagod road, Ratlam
  Pin: 457001
  Contact Nos:
  Email: gouravrathorr@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
09/2019 National group Anthem District level First
09/2018 Yog geet playing Inter School Competition First
01/2015 Fevicryl Be the Change school students from Madhya Pradesh and Chhattisgarh Limca Record
01/2019 Chetna Khel Mela Max Top 10 in my game
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
09/2019 Flute Two months
05/2018 Drum Three months
06/2017 Magic One month
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Studying, health conscious and reading
Why do you wish to join TMI?: This college is best because of its quality of study and course.
What are your hobbies?: Sports, Music and Reading
What are your strengths?: Silence
What are your weaknesses?: Family
How do you intend to meet the expenses of this program?: Bank Loan
 
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.