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: DNS2181505 Name: NISHANT SINGH
  Address: 1695, PUSHPENDRA NAGAR, NEAR VIVEKANAND MAHILA MAHA VIDALAYA NEAR SAHEED PATH, LUCKNOW
Telephone No.: Mobile no: 8005194429
E-mail: rajsinghdoeacc.81@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: 432252590
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2181505 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: DNS2181505
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: NISHANT SINGH
Mother's Name: SANDHYA SINGH
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Dec 2003 Nationality: INDIAN
Place of Birth: GORAKHPUR Personal Identification Mark: A MOLE OF RIGHT THUMB
Blood Group: A + Address for Communication: 1695, PUSHPENDRA NAGAR, NEAR VIVEKANAND MAHILA MAHA VIDALAYA NEAR SAHEED PATH, LUCKNOW
State: Uttar Pradesh Country: India
Pin: 226025 City/District: LUCKNOW
Mobile no: 8005194429 Telephone No. with STD code:
Aadhar Card No:765610132667 E-mail: rajsinghdoeacc.81@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: RAJ KUMAR SINGH Relationship with candidate: FATHER
Parents Date of Birth: 18 Nov 1978 Parent's/Guardian's Occupation/Designation: Sr. TAX ASSISTANT IN INCOME TAX
   
Office Address:
   
Address: AAYKAR BHAWAN 5-ASHOK MARG HAZRATGANJ, LUCKNOW
Country: India State: Uttar Pradesh
City/District: LUCKNOW Pin: 226001
Tel: Mobile no.: 6386163501
Fax: Email: rajsingh81@rediffmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: ARMY PUBLIC SCHOOL School: ARMY PUBLIC SCHOOL
City: LUCKNOW City: LUCKNOW
English %: 96 Board Roll No./Seat No.:
Aggregate Percentage: 97 School/College Code:
  Centre code:
  Address of School/College: ARMY PUBLIC SCHOO, LAL BAHADUR SHASTRI MARG, CANTONMENT, LUCKNOW, UP
  Pin: 226016
  Contact Nos: 05222296931
  Email: apslbslko@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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
09/2017 badminton command cluster level runners up
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparation for JEE and NEET
Why do you wish to join TMI?: It is one of the best college in marine industries.
What are your hobbies?: Computer game and badminton
What are your strengths?: Good observer and quick learner
What are your weaknesses?: trust easily to unknown peoples also
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 not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

___________________

Date ________________

 
Print Summary and Application Form