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: DNS2179259 Name: Mohammad Farhan
  Address: 166 savitri nagar, sanigawan road 166 savitri nagar,sanigawan road
Telephone No.: Mobile no: 9555568694
E-mail: farhan.macro2@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 430448553
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2179259 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: DNS2179259
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohammad Farhan
Mother's Name: Sartaj khatoon
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 28 Oct 2003 Nationality: Indian
Place of Birth: KANPUR Personal Identification Mark: Slight cut in the upper lip
Blood Group: A + Address for Communication: 166 savitri nagar, sanigawan road 166 savitri nagar,sanigawan road
State: Uttar Pradesh Country: India
Pin: 208021 City/District: Kanpur
Mobile no: 9555568694 Telephone No. with STD code:
Aadhar Card No:970881468053 E-mail: farhan.macro2@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Mohammad Imran Relationship with candidate: Father
Parents Date of Birth: 10 Jun 1975 Parent's/Guardian's Occupation/Designation: Government servant
   
Office Address:
   
Address: 166 savitri nagar, sanigawan road, kanpur 166 savitri nagar,sanigawan road,kanpur
Country: India State: Uttar Pradesh
City/District: Kanpur Pin: 208021
Tel: 09838607032 Mobile no.: 9838607032
Fax: Email: farhan.macro2@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: ISCE
School: Guru har Rai academy School: Guru har Rai academy
City: Kanpur City: Kanpur
English %: 69 Board Roll No./Seat No.: 6676055/015
Aggregate Percentage: 79 School/College Code: 129
  Centre code: 2201720
  Address of School/College: Sanigawan Rd, Near Rama Devi, Kanpur, Uttar Pradesh
  Pin: 208021
  Contact Nos: 9565222270
  Email: gha.kanpur@gmail.com
  Aggregate Percentage: 86
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 95 95
Chemistry 100 88 88
Mathematics 100 94 94
Physics, Chemistry & Mathematics combined Percentage: 92.33
English 100 65 65
   
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
11/2021 Volleyball State level Not secured
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I had started preparing for my competitive exams.
Why do you wish to join TMI?: Because it is one of the best placement giving college in shipping line.
What are your hobbies?: Exercising and health care.
What are your strengths?: My greatest strength is my friendly nature with with other people and I think it is very important in board.
What are your weaknesses?: I think I am not so fluent in English but I am working on it.
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 Class XII admit card 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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