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: DNS2180186 Name: YASH NIGAM
  Address: HOUSE NO.H-1536 SATYAM VIHAR, AWAS VIKAS-1 KESHAVPURAM KALYANPUR
Telephone No.: Mobile no: 9415932390
E-mail: pradeepnigam.rk@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 431145345
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2180186 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: DNS2180186
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: YASH NIGAM
Mother's Name: ARTI NIGAM
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Sep 2004 Nationality: Indian
Place of Birth: Kanpur Personal Identification Mark: A cut mark near right eye
Blood Group: A + Address for Communication: HOUSE NO.H-1536 SATYAM VIHAR, AWAS VIKAS-1 KESHAVPURAM KALYANPUR
State: Uttar Pradesh Country: India
Pin: 208017 City/District: KANPUR
Mobile no: 9415932390 Telephone No. with STD code:
Aadhar Card No:840340774196 E-mail: pradeepnigam.rk@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: PRADEEP NIGAM Relationship with candidate: FATHER
Parents Date of Birth: 09 Jan 1974 Parent's/Guardian's Occupation/Designation: Government Service
   
Office Address:
   
Address: Office Of District Magistrate Civil Lines Kanpur Nagar
Country: India State: Uttar Pradesh
City/District: KANPUR Pin: 208001
Tel: 9415932390 Mobile no.: 9415932390
Fax: Email: pradeepnigam.rk@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Maharana Pratap Education Centre School: Maharana Pratap Education Centre
City: KANPUR City: KANPUR
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code:
  Centre code:
  Address of School/College: Keshavpuram, Kalyanpur, Kanpur
  Pin: 208017
  Contact Nos:
  Email: pradeepnigam.rk@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 ?: Preparation of competative exams
Why do you wish to join TMI?: In TMI I will get best training and good placement
What are your hobbies?: Playing musical instrument Tabla
What are your strengths?: achievement of goal
What are your weaknesses?: never give up aim
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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