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: DNS2178591 Name: Rajkumar Gautam
  Address: B-70 samrajya Society nr. Gadkhol patiya Ankleshwar Shivkaran, mahuwa bujurg budhaun chauraha Siddharth nagar, Basti
Telephone No.: Mobile no: 8320246276
E-mail: kraj7733gautam@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: 430290716
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2178591 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: DNS2178591
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Rajkumar Gautam
Mother's Name: Ravita Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 07 Sep 2001 Nationality: Indian
Place of Birth: Basti Personal Identification Mark: Mole on left cheek
Blood Group: O + Address for Communication: B-70 samrajya Society nr. Gadkhol patiya Ankleshwar Shivkaran, mahuwa bujurg budhaun chauraha Siddharth nagar, Basti
State: Gujarat Country: India
Pin: 393010 City/District: Ankleshwar
Mobile no: 8320246276 Telephone No. with STD code:
Aadhar Card No:252110809611 E-mail: kraj7733gautam@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sukairam Relationship with candidate: Grandfather
Parents Date of Birth: 01 Jul 1955 Parent's/Guardian's Occupation/Designation: Retired Executive Engineer
   
Office Address:
   
Address: B-70 samrajya Society nr. Gadkhol patiya Ankleshwar Shivkaran, mahuwa bujurg budhaun chauraha Siddharth nagar, Basti
Country: India State: Gujarat
City/District: Ankleshwar Pin: 393010
Tel: Mobile no.: 9428333599
Fax: Email: krajgodfather777@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Kendriya Vidyalaya School: Kendriya vidyalaya
City: Ankleshwar City: Ankleshwar
English %: 89 Board Roll No./Seat No.: 11606769
Aggregate Percentage: 79 School/College Code: 14103
  Centre code: 1028
  Address of School/College: Gadkhol Patiya, Ankleshwar GIDC, Ankleshwar, Gujarat 393001
  Pin: 393010
  Contact Nos: 09737246459
  Email: kvankleshwar@gmail.com
  Aggregate Percentage: 79
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 88 88
Chemistry 100 63 63
Mathematics 100 75 75
Physics, Chemistry & Mathematics combined Percentage: 75.33
English 100 88 88
   
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 Debate Regional Participated
08/2019 Debate Cluster 2nd
11/2018 NCSC Exhibition Regional Participated
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Providing free education to children in my village, preparing for exam and interview, playing different games and doing gym for fitness.
Why do you wish to join TMI?: TMI is one of the best college for M.N having one of the finest faculty member, it would be a great opportunity for Showcase of my talents and due to the no. Of good shipping companies visiting TMI
What are your hobbies?: Reading hindi Literature, maintaining fitness, trying new food items
What are your strengths?: Emotionally strong, fast learner, good observer, working under pressure
What are your weaknesses?: Not good at communicating in the beginning, Incosistency.
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
 
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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