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: DNS2179304 Name: PAWAN KUMAR
  Address: VILL PO PASAMA PASARMA KONHWA
Telephone No.: Mobile no: 9905706323
E-mail: PAWANKUMAR998011@GMAIL.COM  
   
Application fee payment details:  
Payment Status: Offline Payment Mode: Offline
Amount: DD Number: -
Issuing Bank: - Transaction Id: -
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2179304 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________

   
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: DNS2179304
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PAWAN KUMAR
Mother's Name: ASHA DEVI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Nov 2003 Nationality: INDIAN
Place of Birth: GOPALGANJ Personal Identification Mark: BLACK SPOT ON CHICK
Blood Group: AB + Address for Communication: VILL PO PASAMA PASARMA KONHWA
State: Bihar Country: India
Pin: 841428 City/District: GOPALGANJ
Mobile no: 9905706323 Telephone No. with STD code:
Aadhar Card No:882829080128 E-mail: PAWANKUMAR998011@GMAIL.COM
 
Guardian's Particulars:
 
Name of Parent/Guardian: DILIP PRASAD Relationship with candidate: FATHER
Parents Date of Birth: 06 Apr 1975 Parent's/Guardian's Occupation/Designation: FARMER
   
Office Address:
   
Address: VILL PO PASAMA PASARMA KONHWA
Country: India State: Bihar
City/District: GOPALGANJ Pin: 841428
Tel: Mobile no.: 9934250327
Fax: Email: whyare21@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Bihar Board: Bihar
School: D A V HIGH SCHOOL GOPALGANJ School: D A V HIGH SCHOOL GOPALGANJ
City: GOPALGANJ City: GOPALGANJ
English %: 74 Board Roll No./Seat No.: 21010130
Aggregate Percentage: 73 School/College Code: 10151000107
  Centre code: 43026
  Address of School/College: STATION ROAD GOPALGANJ
  Pin: 841428
  Contact Nos: 9430291638
  Email: mnaryadav@gmail.com
  Aggregate Percentage: 74
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 76 76
Chemistry 100 72 72
Mathematics 100 70 70
Physics, Chemistry & Mathematics combined Percentage: 72.67
English 100 77 77
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Exploring my city
Why do you wish to join TMI?: For better opportunity
What are your hobbies?: Searching on internet
What are your strengths?: Easy to learn anything
What are your weaknesses?: Lazyness
How do you intend to meet the expenses of this program?: Own Resources,Other - BIHAR STUDENT CREDIT CARD
 
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 ________________

 
Print Summary and Application Form