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: DNS2180918 Name: Sumedh Satish Dhage
  Address: M4 A8 uttam value steel complex Link road, bhugaon
Telephone No.: Mobile no: 9158199951
E-mail: smd13dhage@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 434279565
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2180918 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: DNS2180918
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Sumedh Satish Dhage
Mother's Name: Jaya
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 13 Mar 2002 Nationality: Indian
Place of Birth: Chandrapur Personal Identification Mark: Scar on forehead
Blood Group: O + Address for Communication: M4 A8 uttam value steel complex Link road, bhugaon
State: Maharashtra Country: India
Pin: 442001 City/District: Wardha
Mobile no: 9158199951 Telephone No. with STD code:
Aadhar Card No:229506181820 E-mail: smd13dhage@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Satish Relationship with candidate: Father
Parents Date of Birth: 01 Jul 1970 Parent's/Guardian's Occupation/Designation: Senior manager
   
Office Address:
   
Address: Uttam value steel Bhugaon
Country: India State: Maharashtra
City/District: Wardha Pin: 442001
Tel: 07767019766 Mobile no.: 7767019766
Fax: Email: satish1970dhage@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Bhavans Lloyds Vidya Niketan School: Bhavans Lloyds Vidya Niketan
City: wardha City: wardha
English %: 92 Board Roll No./Seat No.: 15622641
Aggregate Percentage: 75 School/College Code: 30020
  Centre code: 3264
  Address of School/College: Lloyds nagar,Link road , Bhugaon ,Wardha
  Pin: 442001
  Contact Nos:
  Email: blvn47@rediffmail.com
  Aggregate Percentage: 73
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 55 55
Chemistry 100 71 71
Mathematics 100 57 57
Physics, Chemistry & Mathematics combined Percentage: 61
English 100 87 87
   
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
01/2013 Shito Ryu Karate State championship Bronze
05/2017 football national open 6
03/2019 Football U19 School division 2
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
02/2021 mixed martial arts 6 months
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Training for mixed martial arts championship . Developing speaking skills.
Why do you wish to join TMI?: TMI is well recognized all over India and has great placements .
What are your hobbies?: sports
What are your strengths?: Communication , Leadership
What are your weaknesses?: Impatient
How do you intend to meet the expenses of this program?: Bank Loan
 
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
 
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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