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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: RAJAN BHARDWAJ
Mother's Name: SARSHWATI SINGH
Gender (M/F): Male Marital Status (Single/Married): Married
Date of Birth (DD/MM/YY): 25 Mar 2002 Nationality: INDIAN
Place of Birth: GADUA Personal Identification Mark: A CUT MARK ON RIGHT SIDE LIP
Blood Group: O + Address for Communication: VILL- GADUA, PO - CHAKANDRA, PS- CHEWARA, DIS- SHEIKHPURA LANDMARK- GADUA GADUA, CHEWARA SHEIKHPURA BIHAR 811304
State: Bihar Country: India
Pin: 811304 City/District: SHEIKHPURA
Mobile no: 7488430769 Telephone No. with STD code:
Aadhar Card No:968928603259 E-mail: rajanbhardwaj827@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: PARMANAND SINGH Relationship with candidate: FATHER
Parents Date of Birth: 20 Jan 1978 Parent's/Guardian's Occupation/Designation: FARMER
   
Office Address:
   
Address: GADUA, CHEWARA SHEIKHPURA BIHAR SHEIKHPURA BIHAR 811304 SHEIKHPURA
Country: India State: Bihar
City/District: SHEIKHPURA Pin: 811304
Tel: Mobile no.: 9572307572
Fax: Email: pnand814@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Bihar Board: Bihar
School: SBJ HIGH SCHOOL School: SBJ HIGH SCHOOL EKARA
City: CHEWARA City: SHEIKHPURA
English %: 69 Board Roll No./Seat No.: 21010100
Aggregate Percentage: 72 School/College Code: 86018
  Centre code: 86018
  Address of School/College: SHEIKHPURA BIHAR
  Pin: 811304
  Contact Nos:
  Email: sbj072@gmail.com
  Aggregate Percentage: 65
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 60 60
Chemistry 100 69 69
Mathematics 100 47 47
Physics, Chemistry & Mathematics combined Percentage: 58.67
English 100 69 69
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
 
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded 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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