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: DNS2180057 Name: Nishant kumar
  Address: Nagaliya lacchmanpur majra nagla khushal Pahasu
Telephone No.: Mobile no: 8279542353
E-mail: nishantt.thakur302@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.83 (Includes Convenience fee of ₹ 4.83 ) DD Number: -
Issuing Bank: - Transaction Id: 431050305
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2180057 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: DNS2180057
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Nishant kumar
Mother's Name: Pinky singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Jan 2004 Nationality: Indian
Place of Birth: Pahasu Personal Identification Mark: Stich marks on right thumb and index finger
Blood Group: AB + Address for Communication: Nagaliya lacchmanpur majra nagla khushal Pahasu
State: Uttar Pradesh Country: India
Pin: 202396 City/District: Bulandshahr
Mobile no: 8279542353 Telephone No. with STD code:
Aadhar Card No:758454861843 E-mail: nishantt.thakur302@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sanjay kumar singh Relationship with candidate: Father
Parents Date of Birth: 10 Dec 1974 Parent's/Guardian's Occupation/Designation: Farmer
   
Office Address:
   
Address: Nagaliya lacchmanpur majra nagla khushal Pahasu
Country: India State: Uttar Pradesh
City/District: Bulandshahr Pin: 202396
Tel: Mobile no.: 9917276151
Fax: Email: nishantt.thakur302@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Three dots sewamarg public school School: Heritage international school
City: Aligarh City: Aligarh
English %: 77 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Centre code:
  Address of School/College: Tala nagri Ramghat road
  Pin: 202001
  Contact Nos:
  Email: hisaligarh@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
Jan/2004 Cricket School level Runner up
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will work on myself and will improve my communication skills
Why do you wish to join TMI?: Tolani is a very big name in the market . TMI has a rich culture of providing education of global standards, with their qualified faculty staff and A class facilities.
What are your hobbies?: Team sports / outdoor activities
What are your strengths?: I am very tough person be it mental or physical strength
What are your weaknesses?: I dont settle for less
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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