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: DNS2178801 Name: Mohd Amber
  Address: House NO.2, 111/108A, Royal Compound Pokharpur, Jajmau
Telephone No.: Mobile no: 9450058950
E-mail: rizviamber786@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 430389672
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2178801 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: DNS2178801
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohd Amber
Mother's Name: Nahid Kausar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Jul 2003 Nationality: Indian
Place of Birth: Unchahar Personal Identification Mark: mole on chin
Blood Group: O + Address for Communication: House NO.2, 111/108A, Royal Compound Pokharpur, Jajmau
State: Uttar Pradesh Country: India
Pin: 208010 City/District: Kanpur
Mobile no: 9450058950 Telephone No. with STD code:
Aadhar Card No:328547786633 E-mail: rizviamber786@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Syed Zulfeqar Husain Relationship with candidate: Father
Parents Date of Birth: 20 Feb 1961 Parent's/Guardian's Occupation/Designation: Retired
   
Office Address:
   
Address: NTPC Pvt. Ltd. Unchahar
Country: India State: Uttar Pradesh
City/District: Rae Bareli Pin: 229406
Tel: 0 Mobile no.: 8004923937
Fax: Email: zulfeqar.husain38@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Chinmaya Vidyalaya School: Chinmaya Vidyalaya
City: Raebareli City: Raebareli
English %: 86 Board Roll No./Seat No.:
Aggregate Percentage: 82 School/College Code:
  Centre code:
  Address of School/College: NTPC Unchahar
  Pin: 229406
  Contact Nos:
  Email: cvunchahar@rediffmail.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
10/2020 Music Competition Campus Level First
11/2019 Volleyball school level second
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I intend to spend my time on my overall development.
Why do you wish to join TMI?: I wish to have the best guidance in my field and that can be achieved through an institution like TMI.
What are your hobbies?: singing
What are your strengths?: I am disciplined and punctual about my life. I am also very passionate about my work and interests.
What are your weaknesses?: Sometimes, I have trouble asking for help.
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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