Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Lateral Entry - B.Tech (Marine Engineering) 2020
Application Summary: Lateral Entry - B.Tech (Marine Engineering)
 
Dossier ID: LTE2056912 Name: PALLAB PATRA
  Address: VILL-EAST SURYAPUR,PO-SURYAPUR,P.S-TITAGARH, DIST-NORTH 24 PGS,
Telephone No.: 9007496909 Mobile no: 8334980190
E-mail: amipallabpatra1998@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1212.73 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 319793169
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2056912 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 ensure that you send the following documents with your application.
  1. Write Application for Lateral Entry - Marine Engineering, Dossier ID on the envelope
  2. Printout of application form along with summary page duly filled and signed wherever indicated
  3. Three identical recent passport size photographs with name & dossier id written at the back
  4. Self – attested copies of Class X mark sheet and Pass Certificate
  5. Self – attested copies of all semester mark sheets and final mark sheet / certificate
  6. Self – attested copies of school/college leaving certificate / transfer certificate
  7. Letter from college mentioning AICTE approval number of the course and college
  8. Copy of Caste Certificate (If any)
  9. Copy of Migration Certificate
  10. Copies of sports and extra-curricular activities (Class VIII and above only)
  11. A non-refundable Demand Draft of Rs. 1200/- favouring “Tolani Maritime Institute” payable at Pune. Write your name, dossier id and contact details on the reverse of the Demand Draft (Kindly ignore if you have paid online)
  12. Please keep a copy of the form for your reference for communicating with the Institute
Send Duly filled application forms to:

Admissions Cell Lateral Entry - B.Tech (Marine Engineering)
Tolani Maritime Institute
Talegaon-Chakan road, Induri,
Talegaon, Pune, Pin- 410507

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Lateral Entry - B.Tech (Marine Engineering)

APPLICATION FOR ADMISSION - 2020
 
Dossier ID: LTE2056912
 
Applicant's Personal Information:
 
Full Name as on Diploma Marksheet/Pass Certificate: PALLAB PATRA
Mother's Name: RINKU PATRA  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 22 Apr 1998 Name as per passport:
Passport No.: Date of Expiry:
Place of Issue: Nationality: INDIAN

(Note: If you do not have passport, you may apply for it as early as possible as passport is required for obtaining Seaman’s Discharge Certificate, mandatory for boarding a ship.)
Place of Birth: Kolkata Personal Identification Mark: BLACK SPOT ON CHEEK
Blood Group: B + Address for Communication: VILL-EAST SURYAPUR,PO-SURYAPUR,P.S-TITAGARH, DIST-NORTH 24 PGS,
State: West Bengal Country: India
Pin: 700121 City/District: Barrackpore
Mobile no: 8334980190 Telephone No. with STD code: 9007496909
Aadhar Card No:256963861633 E-mail: amipallabpatra1998@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: KALI SANKAR PATRA Relationship with candidate: FATHER
Parents Date of Birth: 08 Oct 1969 Parent's/Guardian's Occupation/Designation: SERVICE
   
Office Address:
   
Address: VILL-EAST SURYAPUR,PO-SURYAPUR,P.STITAGARH, DIST-NORTH 24 PGS,
Country: India State: West Bengal
City/District: Kolkata Pin: 700121
Tel: Mobile no.: 9007496909
Fax: Email: sandyroy343@gmail.com
 

Education and Academic Record :
Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2014 Year of Joining: 2017
Board: West Bengal Year of Passing: 2020
School Name: SEWLI HIGH SCHOOL Board: West Bengal
City: Barrackpore Name of College/Institution: REGENT INSTITUTE OF SCIENCE AND TECHNOLOGY
   
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 50 First year: 81
English: 29 Second year: 79
Address of School/College: Debpukur,choto kanthalia Third year:
Pin: 700121 Aggregate Percentage:
Contact Nos:  
Email: amipallabpatra1998@gmail.com  
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
01/2020 WELDING 21 DAYS
 
Why do you wish to join TMI?: THIS INSTITUTION IS BEST FOR MARINE ENGINEERING
What are your hobbies?: DRAWING AND PHOTOGRAPHY
What are your strengths?: SMART WORKING
What are your weaknesses?: EMOTIONAL
How do you intend to meet the expenses of this program?: Bank Loan
 
Declaration

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

Signature of Candidate
 

___________________

Date ________________
 
Print Summary and Application Form