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)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2049760 Name: Mohammed Ashik Rahman
  Address: Badriya house, Mudipu Azad Nagar Bantwal Taluk ,Mangalore-DK
Telephone No.: Mobile no: 7338213195
E-mail: m.ashiq7426422@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 304389949
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049760 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 Diploma in Nautical Science, Dossier ID on the envelope
  2. Print the application form duly filled
  3. Print the application summary duly signed where indicated
  4. Three identical recent passport size photographs with name & dossier id written at the back
  5. Self – attested copies of Class X marksheet and Pass Certificate
  6. 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)
  7. 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)
  8. Self – attested copies of school leaving certificate / transfer certificate (for proof of age)
  9. Self – attested copy of birth certificate (for proof of age and place of birth)
  10. Copies of sports and extra-curricular activities (Class VIII and above only)
  11. Copy of Class XII board exam admit card for those appearing in 2020
  12. 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)
  13. Please keep a copy of the form for your reference for communicating with the Institute

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.

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

 
  Dossier ID: DNS2049760
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Mohammed Ashik Rahman
Mother's Name: Aysha Sulthana
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Feb 2000 Nationality: INDIAN
Place of Birth: Mangalore Personal Identification Mark: Acid Mark on left hand
Blood Group: B + Address for Communication: Badriya house, Mudipu Azad Nagar Bantwal Taluk ,Mangalore-DK
State: Karnataka Country: India
Pin: 574153 City/District: Dakshina Kannada
Mobile no: 7338213195 Telephone No. with STD code:
Aadhar Card No:298547729124 E-mail: m.ashiq7426422@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Abdul Razak Relationship with candidate: Father
Parents Date of Birth: 13 Mar 1970 Parent's/Guardian's Occupation/Designation: Businessman
   
Office Address:
   
Address: Badriya house Mudipu
Country: India State: Karnataka
City/District: Dakshina Kannada Pin: 574153
Tel: Mobile no.: 8550055448
Fax: Email: assa67704@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: Karnataka
School: Kanachur Public School School: Yenepoya Pre-University college
City: Derlakatte City: Mangalore
English %: 93 Board Roll No./Seat No.: 200246
Aggregate Percentage: 93 School/College Code: SS295
  Centre code: XC5913
  Address of School/College: Yenepoya Pre-University college Jeppinamogaru-NH66 Mangalore-575009
  Pin: 575009
  Contact Nos:
  Email: info@yenepoyapuc.com
  Aggregate Percentage: 87
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 89 89
Chemistry 100 81 81
Mathematics 100 91 91
Physics, Chemistry & Mathematics combined Percentage: 87
English 100 83 83
   
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
11/2016 1500m Running Race School Third
11/2016 Kabaddi School First
11/2016 Volleyball School Second
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for the test and interview
Why do you wish to join TMI?: One of the best colleges for DNS in India
What are your hobbies?: Playing,Reading, writing, Traveling
What are your strengths?: I can overcome my weakness , Punctuality
What are your weaknesses?: Procrastination,Too much Kind
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 Class XII marksheet
 
Declaration

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

Signature of Candidate

 

___________________

Date ________________

 
Print Summary and Application Form