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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
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| Application Summary: Lateral Entry - B.Tech (Marine Engineering) |
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| Dossier ID: LTE2057165 |
Name: Shaurya Gurung |
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Address: 21063, Salwood, Mahagun Mywoods Sec 16C, Greater Noida West Gautam Budh Nagar |
| Telephone No.: |
Mobile no: 9312247197 |
| E-mail: shaurya.gurung@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 1225.74 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 320404633 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2057165 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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___________________ |
___________________ |
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| Date ________________ |
Date ________________ |
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| Please quote your dossier id and full name for any future correspondence |
| Please ensure that you send the following documents with your application. |
- Write Application for Lateral Entry - Marine Engineering, Dossier ID on the envelope
- Printout of application form along with summary page duly filled and signed wherever indicated
- Three identical recent passport size photographs with name & dossier id written at the back
- Self – attested copies of Class X mark sheet and Pass Certificate
- Self – attested copies of all semester mark sheets and final mark sheet / certificate
- Self – attested copies of school/college leaving certificate / transfer certificate
- Letter from college mentioning AICTE approval number of the course and college
- Copy of Caste Certificate (If any)
- Copy of Migration Certificate
- Copies of sports and extra-curricular activities (Class VIII and above only)
- 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)
- Please keep a copy of the form for your reference for communicating with the Institute
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| 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
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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
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| Applicant's Personal Information: |
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| Full Name as on Diploma Marksheet/Pass Certificate: Shaurya Gurung |
| Mother's Name: Sangeeta Gurung |
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| Marital Status (Single/Married): Single |
Gender (M/F): Male |
| Date of Birth (DD/MM/YY): 02 Jul 2001 |
Name as per passport:Shaurya Gurung |
| Passport No.: N9692076 |
Date of Expiry: 01 Jul 2019 |
| Place of Issue: Ghaziabad |
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: Dehradun |
Personal Identification Mark: Black spot within the left eye |
| Blood Group: AB - |
Address for Communication: 21063, Salwood, Mahagun Mywoods Sec 16C, Greater Noida West Gautam Budh Nagar |
| State: Uttar Pradesh |
Country: India |
| Pin: 201306 |
City/District: Gautam Budh Nagar |
| Mobile no: 9312247197 |
Telephone No. with STD code: |
| Aadhar Card No:438823741524 |
E-mail: shaurya.gurung@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Sher Bahadur Gurung |
Relationship with candidate: Father |
| Parents Date of Birth: 28 Aug 1969 |
Parent's/Guardian's Occupation/Designation: Sr. Business Analyst |
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| Office Address: |
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| Address: Jacobs Engineering, Plot No. 184, Platinum Tower Udyog Vihar Phase I, Gurugram |
| Country: India |
State: Haryana |
| City/District: Gurugram |
Pin: 122016 |
| Tel: |
Mobile no.: 9899246206 |
| Fax: |
Email: soomangurung@gmail.com |
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Education and Academic Record :
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| Class X: - |
Diploma: - Mechanical Engineering |
| Year of Passing: 2017 |
Year of Joining: 2017 |
| Board: CBSE |
Year of Passing: 2020 |
| School Name: Indirapuram Public School |
Board: Other |
| City: Ghaziabad |
Name of College/Institution: Amity University |
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| Percentage of Marks Secured: |
Details of Marks Secured: (in percentage) |
| Aggregate: 62 |
First year: 67 |
| English: 70 |
Second year: 64 |
| Address of School/College: Indirapuram Public School, Indirapuram
6, Nyaya Khand - I
Ghaziabad
Uttar Pradesh
Pin 201301 |
Third year: |
| Pin: 201301 |
Aggregate Percentage: 65 |
| Contact Nos: 9560994651 |
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| Email: indirapuramps@gmail.com |
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| Why do you wish to join TMI?: Help fulfill my long term dream of joining Merchant Navy and get best placements.
Tolani, as I hear, has the best infrastructure. |
| What are your hobbies?: Photography and music |
| What are your strengths?: Flexibility and adaptability |
| What are your weaknesses?: Sharing my work |
| How do you intend to meet the expenses of this program?: Own Resources |
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| 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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