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: DNS2179773 Name: Mohammad Faizan Ansari
  Address: Muntazipur, Fatuha, Hanumanganj, Prayagraj, Uttar Pradesh 221505 Muntazipur, Fatuha, Hanumanganj, Prayagraj, Uttar Pradesh 221505
Telephone No.: Mobile no: 8840436675
E-mail: faizan23.fa33.fa@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 430756176
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2179773 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: DNS2179773
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohammad Faizan Ansari
Mother's Name: Saista Bano
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 May 2001 Nationality: Indian
Place of Birth: Prayagraj Personal Identification Mark: Birth Mark on right Hand
Blood Group: O + Address for Communication: Muntazipur, Fatuha, Hanumanganj, Prayagraj, Uttar Pradesh 221505 Muntazipur, Fatuha, Hanumanganj, Prayagraj, Uttar Pradesh 221505
State: Uttar Pradesh Country: India
Pin: 221505 City/District: Prayagraj
Mobile no: 8840436675 Telephone No. with STD code:
Aadhar Card No:886759529561 E-mail: faizan23.fa33.fa@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Abu Arfan Ansari Relationship with candidate: Father
Parents Date of Birth: 03 Apr 1972 Parent's/Guardian's Occupation/Designation: Merchant Navy
   
Office Address:
   
Address: Muntazipur, Fatuha, Hanumanganj, Prayagraj, Uttar Pradesh 221505 Muntazipur, Fatuha, Hanumanganj, Prayagraj, Uttar Pradesh 221505
Country: India State: Uttar Pradesh
City/District: Prayagraj Pin: 221505
Tel: Mobile no.: 8957140931
Fax: Email: faizan23.fa33.fa@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2021
Board: ISCE Board: Uttar Pradesh
School: ST Johns CoEd School School: UMA INTER COLLEGE
City: Prayagraj City: Prayagraj
English %: 75 Board Roll No./Seat No.:
Aggregate Percentage: 79 School/College Code:
  Centre code:
  Address of School/College: UMA INTER COLLEGE, JWALAPUR, CHANDOPARA, PRAYAGRAJ
  Pin: 221505
  Contact Nos: 08957140931
  Email: faizan23.fa33.fa@gmail.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:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Having a break. Spending time on sports.
Why do you wish to join TMI?: TMI has good education and placement facilities.
What are your hobbies?: Listening music.
What are your strengths?: Being faithful towards my work and ambition.
What are your weaknesses?: Believing in others.
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

 

___________________

Date ________________

 
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