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: LTE2064674
 
Applicant's Personal Information:
 
Full Name as on Diploma Marksheet/Pass Certificate: Yashrajsinh Jhala
Mother's Name: Rohiniba  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 19 Jan 2001 Name as per passport:Jhala Yashrajsinh Digvijaysinh
Passport No.: T5902138 Date of Expiry: 06 May 2029
Place of Issue: Ahmedabad 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: Bhavnagar Personal Identification Mark: Black mole on throat
Blood Group: B + Address for Communication: Duplex No. 02, Plot No. 176, Ward 8A, Subhash Nagar, Gandhidham
State: Gujarat Country: India
Pin: 370201 City/District: Kutch
Mobile no: 9408488643 Telephone No. with STD code: 02836258643
Aadhar Card No: E-mail: zalarohiniba@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Digvijaysinh Relationship with candidate: Father
Parents Date of Birth: 20 Apr 1973 Parent's/Guardian's Occupation/Designation: Marine Surveyor
   
Office Address:
   
Address: S-208, Silver Arc, Plot No. 57, Sector 8, Tagore Road Gandhidham
Country: India State: Gujarat
City/District: Kutch Pin: 370201
Tel: 0236258643 Mobile no.: 9825118643
Fax: Email: zala.ds@gmail.com
 

Education and Academic Record :
Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2017 Year of Joining: 2017
Board: CBSE Year of Passing: 2020
School Name: Amarchand Singhvi Int School Board: Madhya Pradesh
City: Gandhidham Name of College/Institution: Dr. A. P. J. Abdul Kalam University
   
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 72 First year: 66
English: 76 Second year: 68
Address of School/College: Parekh Parisar, Ward 7A, Gandhidham Third year:
Pin: 370201 Aggregate Percentage:
Contact Nos: 02836257500  
Email: singhvischool@gmail.com  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
07/2016 Rifle Shooting District Leval 1st Position
 
Why do you wish to join TMI?: Better career prospects and good learning
What are your hobbies?: Rifle shooting, Steel forging and cycling
What are your strengths?: Ability to learn from mistakes, creative thinking, task prioritisation and discipline and determination
What are your weaknesses?: None
How do you intend to meet the expenses of this program?: Own Resources
 
Declaration

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

Signature of Candidate
 

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Date ________________