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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Omkar Sanjay Pant
Mother's Name: Bablu Pant Shashi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Sep 2002 Nationality: Indian
Place of Birth: Pithoragarh Personal Identification Mark: White spot on left leg
Blood Group: A + Address for Communication: A5/59 VRINDAVAN ESTATE COLONY DHAURERA MAFI NEAR PILIBHIT BYEPASS ROAD BAREILLY U.P.
State: Uttar Pradesh Country: India
Pin: 243122 City/District: Bareilly
Mobile no: 9411596500 Telephone No. with STD code: 9411596500
Aadhar Card No:618795615022 E-mail: omkarpant121@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sanjay Pant Relationship with candidate: Father
Parents Date of Birth: 28 Aug 1976 Parent's/Guardian's Occupation/Designation: Doctor
   
Office Address:
   
Address: A5/59 VRINDAVAN ESTATE COLONY DHAURERA MAFI NEAR PILIBHIT BYEPASS ROAD BAREILLY U.P.
Country: India State: Uttar Pradesh
City/District: Bareilly Pin: 243122
Tel: Mobile no.: 9997088291
Fax: Email: omkarpant121@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: Uttaranchal
School: Bedi International School School: Dayanand Inter College
City: Bareilly City: Pithoragarh
English %: 71 Board Roll No./Seat No.: 20470337
Aggregate Percentage: 63 School/College Code: 108
  Centre code: 114
  Address of School/College: Near Takana, Pithoragarh
  Pin: 262501
  Contact Nos:
  Email: omkarpant121@gmail.com
  Aggregate Percentage: 60
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 64 64
Chemistry 100 58 58
Mathematics 100 62 62
Physics, Chemistry & Mathematics combined Percentage: 61.33
English 100 63 63
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: mk
Why do you wish to join TMI?: ok
What are your hobbies?: kij
What are your strengths?: jij
What are your weaknesses?: jni
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded 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 ________________

 
Print Summary and Application Form