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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
(New Admission Diploma in Nautical Science 2020)
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| Application Summary: Diploma in Nautical Science |
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| Dossier ID: DNS2049494 |
Name: GUPTA MANISH UMESH GEETA |
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Address: c/3 karmaboomi apt jain mandir road virar west d/5 karmaboomi apt jain mandir road virar west |
| Telephone No.: |
Mobile no: 9588460262 |
| E-mail: gmanish4126@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 303983430 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049494 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 Diploma in Nautical Science, Dossier ID on the envelope
- Print the application form duly filled
- Print the application summary duly signed where indicated
- Three identical recent passport size photographs with name & dossier id written at the back
- Self – attested copies of Class X marksheet and Pass Certificate
- Self – attested copies of Class XII marksheet and Pass Certificate (Candidates appearing for Class XII exam in 2020 may submit these copies after declaration of results)
- Self – attested copies of class XII marksheet downloaded from internet (Candidates appearing for Class XII exam in 2020 may submit these copies after declaration of results)
- Self – attested copies of school leaving certificate / transfer certificate (for proof of age)
- Self – attested copy of birth certificate (for proof of age and place of birth)
- Copies of sports and extra-curricular activities (Class VIII and above only)
- Copy of Class XII board exam admit card for those appearing in 2020
- A non-refundable Demand Draft of Rs. 200/- 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 (DNS)
Tolani Maritime Institute
Talegaon-Chakan road, Induri,
Talegaon, Pune, Pin- 410507
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. |
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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
(New Admission Diploma in Nautical Science )
APPLICATION FOR ADMISSION - 2020
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| Applicant's Personal Information: |
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| Full Name as on Class XII Marksheet/Pass Certificate: GUPTA MANISH UMESH GEETA |
| Mother's Name: Geeta gupta |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 03 Apr 2000 |
Nationality: INDIAN |
| Place of Birth: UP |
Personal Identification Mark: A mole on lips |
| Blood Group: O + |
Address for Communication: c/3 karmaboomi apt jain mandir road virar west d/5 karmaboomi apt jain mandir road virar west |
| State: Maharashtra |
Country: India |
| Pin: 401303 |
City/District: palghar |
| Mobile no: 9588460262 |
Telephone No. with STD code: |
| Aadhar Card No:854036106448 |
E-mail: gmanish4126@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Umesh gupta |
Relationship with candidate: father |
| Parents Date of Birth: 03 Jan 1976 |
Parent's/Guardian's Occupation/Designation: LIC |
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| Office Address: |
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| Address: d/5 karmaboomi apt jain mandir road virar west c/3 karmaboomi apt jain mandir road virar west |
| Country: India |
State: Maharashtra |
| City/District: palghar |
Pin: 401303 |
| Tel: |
Mobile no.: 7263061219 |
| Fax: |
Email: gogleuser200@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2017 |
Year of Passing: 2019 |
| Board: Maharashtra |
Board: Maharashtra |
| School: st.james english high scool |
School: p.r.p. utkarsha |
| City: virar |
City: virar |
| English %: 68 |
Board Roll No./Seat No.: M036099 |
| Aggregate Percentage: 62 |
School/College Code: 1808007 |
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Centre code: 2321 |
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Address of School/College: viva college near old viva road |
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Pin: 401305 |
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Contact Nos: |
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Email: gmanish4126@gmail.com |
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Aggregate Percentage: 60 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
47 |
47 |
| Chemistry |
100 |
51 |
51 |
| Mathematics |
100 |
44 |
44 |
| Physics, Chemistry & Mathematics combined Percentage: |
47.33 |
| English |
100 |
68 |
68 |
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| IMU CET Application Number: CET19U99612 |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: GETTING MORE KNOWLEDGE ABOUT INSTITUTE |
| Why do you wish to join TMI?: THERE IS ONE OF MY FRIEND STUDYING |
| What are your hobbies?: READING NOVELS |
| What are your strengths?: TO COMPLETE THE TASK GIVEN |
| What are your weaknesses?: EMOTIONAL ON SMALL THINGS |
| How do you intend to meet the expenses of this program?: Bank Loan |
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| Review you documents: |
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Birth certificate
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DGS Approved Medical Fitness Certificate not uploaded
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Class X marksheet
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School leaving certificate not uploaded
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Class XII admit card not uploaded
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Class XII marksheet not uploaded
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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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